Organization
CHANGING LIVES FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATRINA BANKS (OWNER)
(912) 247-9567
Entity
Organization
Contact information
Practice address
4406 INDIAN RIVER RD, CHESAPEAKE, VA 23325-3131
(912) 247-9567
(804) 884-3702
Mailing address
4406 INDIAN RIVER RD, CHESAPEAKE, VA 23325-3131
(912) 247-9567
(804) 884-3702
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/08/2020
Last updated
07/04/2025
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