NPIMap

Organization Active NPI

Life Changing Family Care, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
National Provider Identifier
1174232482
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIFE CHANGING FAMILY CARE, LLC
Practice address
3411 Office Park Dr
Dayton, OH 45439-2298
Phone
(937) 802-5440
NPI assigned
Nov 16, 2022
Last updated
Oct 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Aiofimi MartinNPI 1114502697
Title
President
Phone
(937) 802-5440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

3411 Office Park Dr
Dayton, OH 45439-2298

Mailing address

3411 Office Park Dr
Dayton, OH 45439-2298

Other identifiers 1

IdentifierTypeStateIssuer
0411413MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL www.lifechangingfamilycare.com
Other URL www.lifechangingfamilycare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230117000794 OH Part B Supplier - Clinic/Group Practice 4486025186 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kettering, OH

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Life Changing Family Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1628 Springfield St
Dayton, OH 45403
Phone (888) 202-4232

3411 Office Park Dr
Kettering, OH 45439
Phone (937) 802-5440

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1174232482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 OFFICE PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454392298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 OFFICE PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454392298",
            "telephone_number": "937-802-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGING FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "AIOFIMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-802-5440"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0411413",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.lifechangingfamilycare.com",
            "affiliation": "N",
            "address_1": "1628 Springfield St",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454031430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.lifechangingfamilycare.com",
            "affiliation": "N",
            "address_1": "3411 Office Park Dr",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454392298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.