Life Center for Change

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIFE CENTER FOR CHANGE

Practice address

240 S 5TH W Ste D
Rigby, ID 83442-1476

Phone

(208) 745-0467

Fax

(208) 745-0409

NPI assigned

Dec 3, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Colleen Gray

Title

Owner

Phone

(208) 745-0467

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720156011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S 5TH W STE D",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834421476",
            "telephone_number": "208-745-0467",
            "fax_number": "208-745-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S 5TH W STE D",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834421476",
            "telephone_number": "208-745-0467",
            "fax_number": "208-745-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CENTER FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-745-0467",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James G Lamb, AU.D.
• Fallyn Ray Lambertsen, PHARMD
• Kelsey Bryn Larson, M.S., CCC-SLP
• Kathy Lebaron, L.M., C.P.M
• Richard Garrett Lee, MD
• Braden Lott, DPT
• Lotus Wellness Inc
• Julie Kaye Macki
• Madison Co Memorial Hospital
• Mark L. Peterson

• Community/Behavioral Health Agency in Rigby, ID
• Providers in Rigby, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.