NPIMap

Organization Active NPI

Changing Lives Family Care of Georgia LLC

  • Personal Care Attendant
  • Savannah, GA
National Provider Identifier
1013500420
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Legal business name
CHANGING LIVES FAMILY CARE OF GEORGIA LLC
Practice address
100 Bull St Ste 200
Savannah, GA 31401-3378
Phone
(757) 739-1666
Fax
(804) 884-3702
NPI assigned
Feb 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Catrina Banks
Title
Owner
Phone
(757) 739-1666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X Primary

Addresses

Primary practice location

100 Bull St Ste 200
Savannah, GA 31401-3378

Mailing address

100 Bull St Ste 200
Savannah, GA 31401-3378
Phone (757) 739-1666

Other identifiers 2

IdentifierTypeStateIssuer
251E00000XMedicaidGA
3747P1801XMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL BUSINIESS Direct

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1013500420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BULL ST STE 200",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314013378",
            "telephone_number": "757-739-1666",
            "fax_number": "804-884-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BULL ST STE 200",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314013378",
            "telephone_number": "757-739-1666",
            "fax_number": "804-884-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING LIVES FAMILY CARE OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "CATRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-739-1666"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251E00000X",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3747P1801X",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BUSINIESS",
            "affiliation": "N",
            "endpointDescription": "CHANGINGLIVESCEO@GMAIL.COM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "BUSINIESS",
            "address_1": "100 Bull St Ste 200",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314013378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.