CHANGE YOUR LIFE ENTERPRISES INC. NPI 1003895988

NPI Information

NPI: 1003895988
Provider Name: CHANGE YOUR LIFE ENTERPRISES, INC.
Classification: Clinic/Center - 261QR0405X
Specialization: Rehabilitation, Substance Use Disorder
Entity Type: Organization
Doing Business As: ADAPT, GRIP & STEPHENIE ROBERTS, LSCSW
Address: 9505 W. CENTRAL
STE. 103
WICHITA, KS
ZIP 67212
Phone: (316) 721-0971

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NPI Details

CHANGE YOUR LIFE ENTERPRISES, INC. is a rehabilitation and substance use disorder clinic center in Wichita, KS. CHANGE YOUR LIFE ENTERPRISES, INC. NPI is 1003895988. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Adapt, Grip & Stephenie Roberts, Lscsw.

The provider's business location address is:

9505 W. CENTRAL
STE. 103
WICHITA, KS
ZIP 67212-832
Phone: (316) 721-0971
Fax: (316) 512-4070

The provider's authorized official is Stephenie Ann Roberts .
The authorized official title is President/owner and has the following contact phone number (316) 721-0971.

The enumeration date for this NPI number is 1/10/2006 and was last updated on 7/15/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)		KANSAS	No
2	1041C0700X	Social Worker	Clinical	1949	KANSAS	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	547	KANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	565012	MEDICAID	KANSAS
2	116049	MEDICARE ID-TYPE UNSPECIFIED	KANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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