| NPI | 1790291334 |
|---|---|
| Doing Business As | LIFECHANGERS IOP |
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOHNSON Executive Director 865-805-0567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TN 1000000021300) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2018-09-25 |