Life Change Outreach Organization

Organization Active NPI Case Manager/Care Coordinator · Mascotte, FL

NPI 1992057723 · NPPES record last updated Oct 3, 2012

Key facts

NPI
1992057723
Entity type
Organization (NPI type 2)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Legal business name
LIFE CHANGE OUTREACH ORGANIZATION
Practice address
15508 Willet CT
Mascotte, FL 34753-9102
Phone
(352) 255-6458
NPI assigned
Oct 3, 2012
Organization subpart
No

Authorized official

Name
Mrs. Nabuchi Grace Anderson
Title
Owner
Phone
(352) 255-6458

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
Life Change Outreach Organization (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator
Group: 193400000X SINGLE SPECIALTY GROUP
171M00000X Yes

Addresses

Primary practice location

15508 Willet CT
Mascotte, FL 34753-9102

Mailing address

15508 Willet CT
Mascotte, FL 34753-9102
Phone (352) 255-6458

Other providers in Mascotte, FL

All providers in Mascotte, FL · Case Manager/Care Coordinator in Florida

Sources for this page

Verify at the official NPI Registry.