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CHANGING LIVES WELLNESS LLC
NPI 1144162835
Nurse Practitioner - Psychiatric/Mental Health in Grand Rapids, MI

Active since April 09, 2026
625 KENMOOR AVE SE # 150434, GRAND RAPIDS, MI 49546(248) 413-5013 Get Directions Write a Review

NPPES record last updated: April 9, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Changing Lives Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANGING LIVES WELLNESS LLC (NPI 1144162835) is a healthcare organization registered as a psychiatric/mental health in Grand Rapids, Michigan and active in the NPI registry since April 2026. The organization lists Brian Mangenje, Owner / Np / Provider, as its authorized official.

NPPES Registry Identity

NPI1144162835
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameCHANGING LIVES WELLNESS LLC
Location Address625 KENMOOR AVE SE # 150434Grand Rapids, MI 49546-2395
Mailing Address625 Kenmoor Ave Se # 150434Grand Rapids, MI 49546-2395 · (248) 413-5013
Phone(248) 413-5013
Organization SubpartNo
Authorized OfficialBrian MangenjeOwner / Np / Provider · (248) 413-5013
Enumeration DateApril 9, 2026
NPPES CertifiedApril 9, 2026
✔ NPI 1144162835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
625 KENMOOR AVE SE # 150434, Grand Rapids, MI 49546
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Reviews for CHANGING LIVES WELLNESS LLC

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Frequently Asked Questions

What is CHANGING LIVES WELLNESS LLC's NPI number?

The NPI number assigned to this healthcare provider is 1144162835, enumerated as an "organization" on April 09, 2026.

Where is the provider located?

The provider is located at 625 KENMOOR AVE SE # 150434 GRAND RAPIDS, MI 49546 and the phone number is (248) 413-5013.

What is the provider's specialty?

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.