Organization
LIFE CHANGING INITIATIVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA HARRIS (PRESIDENT/CEO)
(520) 306-9770
Entity
Organization
Contact information
Practice address
4539 N 22ND ST STE 5174, PHOENIX, AZ 85016-4639
(520) 306-9770
Mailing address
4539 N 22ND ST STE 5174, PHOENIX, AZ 85016-4639
(520) 306-9770
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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