Organization
LIFE CHANGE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON R SWIFT LSW MSSA (EXECUTIVE DIRECTR)
(216) 376-2886
Entity
Organization
Contact information
Practice address
1510 E 221ST ST, EUCLID, OH 44117-1509
(216) 376-2886
Mailing address
PO BOX 604002, CLEVELAND, OH 44104-0002
(216) 376-2886
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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