Life Changing Adult Daycare

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

LIFE CHANGING ADULT DAYCARE

Practice address

305 Birch Ave
Indianola, MS 38751-2107

Phone

(662) 207-3645

NPI assigned

Jan 12, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Pamela Lorraine Randle

Title

Owner

Phone

(662) 207-3645

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452556800000",
    "number": "1659737286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53",
            "address_2": "2110 KINLOCK ROAD",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387510053",
            "telephone_number": "662-207-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BIRCH AVE",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512107",
            "telephone_number": "662-207-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGING ADULT DAYCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A",
        "authorized_official_last_name": "RANDLE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-207-3645",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lean on Me, LLC
• Liberty Health & Rehab of Indianola, LLC
• Light of the World Adult Day Care, LLC
• Jacquelyne Brown Little, FNP
• Andrew B Lott, CRNA
• Lovett Chiropractic Inc.
• James Michael Lovett, D.C.

• Case Manager/Care Coordinator in Indianola, MS
• Providers in Indianola, MS by specialty
• Case Manager/Care Coordinator in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.