Organization
THE LIFE CHANGE CENTER
Active
Other names
American Therapeutic Association
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN ZELLER DO (MEDICAL DIRECTOR)
(775) 355-7734
Entity
Organization
Contact information
Practice address
130 VINE ST, RENO, NV 89503-5546
(775) 499-5534
(775) 355-7759
Mailing address
1755 SULLIVAN LN, SPARKS, NV 89431-2815
(775) 355-7734
(775) 355-7759
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
138101
NV
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001716006
—
NV
Enumeration date
05/05/2006
Last updated
06/17/2024
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