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CHANGING LIVES GROUP HOME III LLC NPI 1881144186


NPI Information

NPI: 1881144186
Provider Name: CHANGING LIVES GROUP HOME III, LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 34D2149331

Address:
636 GUNN ST
BURLINGTON, NC
ZIP 27217
Phone: (336) 516-6187
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CHANGING LIVES GROUP HOME III, LLC is an adult care home custodial care facility in Burlington, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. CHANGING LIVES GROUP HOME III, LLC NPI is 1881144186. The provider is registered as an organization entity type.

The provider's business location address is:

636 GUNN ST
BURLINGTON, NC
ZIP 27217-508
Phone: (336) 516-6187

The provider's authorized official is Jaquay Wade .
The authorized official title is Director and has the following contact phone number (336) 516-6187.

The CLIA number assigned to this NPI record is 34D2149331 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2016 and was last updated on 12/2/2016.


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
1311ZA0620XCustodial Care FacilityAdult Care HomeNORTH CAROLINAYes

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: 5/5/2024

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