Organization Active NPI

Changeforbetterlife

  • Adult Day Care Clinic/Center
  • Pembroke Pines, FL
National Provider Identifier
1245498799
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
CHANGEFORBETTERLIFE
Practice address
7511 NW 1St St
Pembroke Pines, FL 33024-7001
Phone
(954) 966-6680
Fax
(954) 966-6680
NPI assigned
May 30, 2008
Last updated
May 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Mrs. Dolores Gant
Title
President
Phone
(954) 966-6680

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X FL Primary
Community/Behavioral Health Agency 251S00000X 101543FH FL

Addresses

Primary practice location

7511 NW 1St St
Pembroke Pines, FL 33024-7001

Mailing address

7511 NW 1St St
Pembroke Pines, FL 33024-7001
Phone (954) 966-6680

Other identifiers 1

IdentifierTypeStateIssuer
675005296MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1245498799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 NW 1ST ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330247001",
            "telephone_number": "954-966-6680",
            "fax_number": "954-966-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 NW 1ST ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330247001",
            "telephone_number": "954-966-6680",
            "fax_number": "954-966-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGEFORBETTERLIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "GANT",
        "authorized_official_first_name": "DOLORES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-966-6680",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "101543FH",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "675005296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.