Organization
LYFE CHANGES LLC
Active
Other names
James J Young
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J YOUNG (MANAGING MEMBER)
(407) 314-0383
Entity
Organization
Contact information
Practice address
7415 GATEHOUSE CIR, APT 180, ORLANDO, FL 32807-6011
(407) 314-0383
(407) 964-3238
Mailing address
7415 GATEHOUSE CIR, APT 180, ORLANDO, FL 32807-6011
(407) 314-0383
(407) 964-3238
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014194400
—
FL
Enumeration date
02/15/2017
Last updated
02/15/2017
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