Changing Lives Agency

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

CHANGING LIVES AGENCY

Practice address

5284 Floyd Rd SW Unit 2079
Mableton, GA 30126-6120

Phone

(678) 396-1803

NPI assigned

May 25, 2026

Organization subpart

No

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

Authorized official

Name

Boniat Jemison

Title

Owner

Phone

(678) 396-1803

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1779667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779667200000",
    "number": "1457282980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5284 FLOYD RD SW UNIT 2079",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301266120",
            "telephone_number": "678-396-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5284 FLOYD RD SW UNIT 2079",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301266120",
            "telephone_number": "678-396-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING LIVES AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-25",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A",
        "authorized_official_last_name": "JEMISON",
        "authorized_official_first_name": "BONIAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-396-1803"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Mableton, GA
• Providers in Mableton, GA by specialty
• Preferred Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; 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.