Organization
LIFE CHANGE OUTREACH ORGANIZATION, INC
Active
Other names
LCO
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NABUCHI G ANDERSON REGISTERED MHC (PROGRAM MANAGER, OWNER)
(352) 255-6458
Entity
Organization
Contact information
Practice address
55 BLUFF LAKE RD, SUITE A, MASCOTTE, FL 34753-9501
(352) 255-6458
(352) 410-6118
Mailing address
55 BLUFF LAKE RD, SUITE A, MASCOTTE, FL 34753-9501
(352) 255-6458
(352) 410-6118
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251E00000X
Home Health Agency
232916
FL
253Z00000X
In Home Supportive Care Agency
232916
FL
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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