NPIMap

Organization Active NPI

Life Changing Family Care, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kettering, OH
National Provider Identifier
1972213700
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIFE CHANGING FAMILY CARE, LLC
Practice address
3411 Office Park Dr
Kettering, OH 45439-2298
Phone
(937) 802-5440
NPI assigned
Dec 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Aiofimi Martin
Title
President
Phone
(937) 802-5440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3411 Office Park Dr
Kettering, OH 45439-2298

Mailing address

3411 Office Park Dr
Kettering, OH 45439-2298
Phone (937) 802-5440

Other identifiers 1

IdentifierTypeStateIssuer
0411413MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL www.lifechangingfamilycare.com
Other URL lifechangingfamilycare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230117000794 OH Part B Supplier - Clinic/Group Practice 4486025186 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
Practice locations: Kettering, OH

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Life Changing Family Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1972213700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 OFFICE PARK DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454392298",
            "telephone_number": "937-802-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 OFFICE PARK DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454392298",
            "telephone_number": "937-802-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGING FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "AIOFIMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-802-5440"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0411413",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.lifechangingfamilycare.com",
            "affiliation": "N",
            "address_1": "3411 Office Park Dr",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454392298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "lifechangingfamilycare.com",
            "affiliation": "N",
            "address_1": "3411 Office Park Dr",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454392298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.