OrganizationActive
The Life Change Center
NPI 1205389129 · Addiction (Substance Use Disorder) Psychologist · Sparks, NV
Provider details
- NPI number
- 1205389129
- Entity type
- Organization
- Primary specialty
- Addiction (Substance Use Disorder) PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- John Firestone, Executive Director(775) 842-7436
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Methadone Clinic261QM2800X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
1755 Sullivan Ln
Sparks, NV 89431-2815
Phone: (775) 499-5534
Fax: (775) 499-5535
Approximate (ZIP-level) locationGet directions
Mailing address
1755 Sullivan Ln
Sparks, NV 89431-2815
Registry dates
- Enumerated
- 2016-07-27
- Last updated
- 2024-06-17
- Certified
- 2024-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.