| The Life Change Center | |
|
1201 N Stewart St Ste 120 Carson City NV 89706-3004 | |
| (775) 350-7250 | |
| (775) 499-5535 |
| Full Name | The Life Change Center |
|---|---|
| Speciality | Psychologist - Addiction (substance Use Disorder) |
| Location | 1201 N Stewart St Ste 120, Carson City, Nevada |
| Authorized Official Name and Position | John Firestone (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7754995534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Life Change Center 1755 Sullivan Ln Sparks NV 89431-2815 Ph: (775) 499-5534 | The Life Change Center 1201 N Stewart St Ste 120 Carson City NV 89706-3004 Ph: (775) 350-7250 |
| NPI Number | 1841743762 |
|---|---|
| Provider Enumeration Date | 07/27/2016 |
| Last Update Date | 10/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841743762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | 8312NTC-01 (Nevada) | Primary |
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