Organization
LIFE CHANGES - WINSTON SALEM
Active
Parent organization
LIFE CHANGES HOME CARE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE CHANGES HOME CARE, INC
Authorized official
MR. CEDRIC MOORE (ADMINISTRATOR)
(704) 537-0096
Entity
Organization
Contact information
Practice address
1001 S MARSHALL ST, SUITE 1-75, WINSTON SALEM, NC 27101-5852
(704) 537-0096
(704) 537-6080
Mailing address
1001 E WT HARRIS BLVD, SUITE P-192, CHARLOTTE, NC 28213-4104
(704) 537-0096
(704) 537-6080
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4410
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601750
—
NC
Enumeration date
11/23/2011
Last updated
11/23/2011
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