Provider Demographics
NPI:1306309356
Name:LIFE CHANGING CARE LLC
Entity type:Organization
Organization Name:LIFE CHANGING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ARENA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:302-494-1968
Mailing Address - Street 1:601 WELDIN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4941
Mailing Address - Country:US
Mailing Address - Phone:302-494-1968
Mailing Address - Fax:302-764-3735
Practice Address - Street 1:601 WELDIN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-4941
Practice Address - Country:US
Practice Address - Phone:302-494-1968
Practice Address - Fax:302-764-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility