Organization
LIFE CHANGING SUPPORT SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH STILES (VICE PRESIDENT)
(814) 330-3694
Entity
Organization
Contact information
Practice address
112 ST. BENEDICT ST, CARROLLTOWN, PA 15722
(814) 330-3694
Mailing address
PO BOX 622, 112 ST. BENEDICT ST, CARROLLTOWN, PA 15722
(814) 330-3694
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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