Organization
CHANGING LIVES HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDON JACKSON (FOUNDER)
(414) 477-9466
Entity
Organization
Contact information
Practice address
4911 W GOOD HOPE RD, MILWAUKEE, WI 53223-4840
(414) 477-9644
Mailing address
4911 W GOOD HOPE RD, MILWAUKEE, WI 53223-4840
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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