Organization
CHANGING LIVES NETWORKS INC
Active
Organization
CHANGING LIVES NETWORKS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAQUAY WADE (DIRECTOR)
(336) 516-6187
Entity
Organization
Contact information
Practice address
1020 BROOKSTOWN AVE STE 5&6, WINSTON SALEM, NC 27101-2523
(336) 293-6535
Mailing address
823 DAY AVE, BURLINGTON, NC 27217-2505
(336) 516-6187
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/14/2022
Last updated
02/21/2023
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