Changing Lives Therapeutic Service,Llc
LBN: Changing Lives Therapeutic Service, Llc
Changing Lives Therapeutic Service,Llc is an health care organization with primary practice located at 413 Mount Cross Rd Ste 102 , Danville VA 24540-4089. The organization recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Other Service Providers / Peer Specialist, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty.
Changing Lives Therapeutic Service, Llc can be contacted via phone (888) 388-8726, or through Rolle, Cemetrius via phone (980) 833-1121.
Contact Information
Primary practice address
413 Mount Cross Rd Ste 102
Danville VA 24540-4089
Phone: (888) 388-8726
Fax:
Website:
Authorized official contact:
Name: Rolle, Cemetrius Licensed Clinical Social Worker (LCSW)
Phone: (980) 833-1121
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | ||
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Other Service Providers / Peer Specialist | 175T00000X | ||
| Agencies / Community/Behavioral Health | 251S00000X | ||
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | ||
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X |
Profile Details
| NPI number | 1891317657 |
|---|---|
| LBN Legal business name | Changing Lives Therapeutic Service, Llc |
| DBA Doing business as | Changing Lives Therapeutic Service,Llc |
| Authorized official | Rolle, Cemetrius Licensed Clinical Social Worker (LCSW) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 14th, 2020 |
| Last updated | Jun 15th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891317657 | NPPES |
| North Carolina | MEDICAID | 1295117760 | |
| North Carolina | MEDICAID | 1922582998 |
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