Provider Demographics
NPI:1356102206
Name:LIFE CHANGING LLC
Entity type:Organization
Organization Name:LIFE CHANGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:859-940-0767
Mailing Address - Street 1:114 BILL PERKINS LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8590
Mailing Address - Country:US
Mailing Address - Phone:859-321-3647
Mailing Address - Fax:
Practice Address - Street 1:114 BILL PERKINS LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8590
Practice Address - Country:US
Practice Address - Phone:859-347-7473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)