Life Change Outreach Organization

LBN: Life Change Outreach Organization
Life Change Outreach Organization is an health care organization with primary practice located at 1135 Tenth St Suite A, Clermont FL 34711. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Other Service Providers / Case Manager/Care Coordinator, Managed Care Organizations / Point of Service. Other Service Providers / Case Manager/Care Coordinator is the primary health care specialty. Life Change Outreach Organization can be contacted via phone (352) 255-6458, or through Anderson, Nabuchi Grace via phone (352) 255-6458.

Contact Information

Primary practice address
1135 Tenth St Suite A Clermont FL 34711
Phone: (352) 255-6458
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Nabuchi Grace
Phone: (352) 255-6458

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Managed Care Organizations / Point of Service 305S00000X

Profile Details

NPI number 1467704437
LBN Legal business name Life Change Outreach Organization
DBA Doing business as
Authorized official Anderson, Nabuchi Grace
Entity Organization
Organization subpart 1 No
Enumeration date Oct 15th, 2012
Last updated Oct 15th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467704437 NPPES
Florida MEDICAID 004444700

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