Changemaker, Inc.

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

CHANGEMAKER, INC.

Doing business as

Massage by Litahni

Practice address

4165 Shoreline Dr
#50
Spring Park, MN 55384-9659

Phone

(763) 427-0212

NPI assigned

Apr 19, 2011

Last updated

Apr 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Litahni F Coleman, CMT, CTC

Title

Ceo

Phone

(763) 427-0212

Specialties & licenses 1

Addresses

Other names 1

• Massage by Litahni Doing business as

Locations

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1508156977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 MARION LN W",
            "address_2": "#3204",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051376",
            "telephone_number": "763-427-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 SHORELINE DR",
            "address_2": "#50",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553849659",
            "telephone_number": "763-427-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGEMAKER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "LITAHNI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-427-0212",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMT, CTC"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Massage by Litahni",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.