Provider Demographics
NPI:1710773304
Name:2018 LIFE CHANGERS LLC
Entity type:Organization
Organization Name:2018 LIFE CHANGERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRUDENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-683-1260
Mailing Address - Street 1:515 N SAM HOUSTON PKWY E STE 208
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4133
Mailing Address - Country:US
Mailing Address - Phone:832-683-1260
Mailing Address - Fax:
Practice Address - Street 1:723 PHILLIPS AVE BLDG E
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1351
Practice Address - Country:US
Practice Address - Phone:832-683-1260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health