Provider Demographics
NPI:1912776030
Name:A LIFE CHANGING LLC
Entity type:Organization
Organization Name:A LIFE CHANGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASKINS MURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-528-3240
Mailing Address - Street 1:917 W ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-2916
Mailing Address - Country:US
Mailing Address - Phone:702-528-3240
Mailing Address - Fax:
Practice Address - Street 1:917 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2916
Practice Address - Country:US
Practice Address - Phone:702-528-3240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services