CHANGING LIVES WELLNESS LLC
NPI 1144162835
Nurse Practitioner - Psychiatric/Mental Health in Grand Rapids, MI
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
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Changing Lives Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Changing Lives Wellness LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Changing Lives Wellness LLC's NPI number?
The NPI number for Changing Lives Wellness LLC is 1144162835. It was assigned to this organization in the NPPES registry on April 9, 2026.
Where is Changing Lives Wellness LLC located?
Changing Lives Wellness LLC is located at 625 Kenmoor Ave SE # 150434, Grand Rapids, MI 49546. The listed phone number is (248) 413-5013.
What is Changing Lives Wellness LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Changing Lives Wellness LLC enrolled in Medicare?
Yes. Changing Lives Wellness LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Changing Lives Wellness LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Changing Lives Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Changing Lives Wellness LLC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Changing Lives Wellness LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Changing Lives Wellness LLC was last updated on April 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Changing Lives Wellness Llc · NPI 1144162835
Psychiatric/Mental Health organization in Grand Rapids, Michigan. Organization record, active in the CMS NPPES registry since April 9, 2026.
## Identity
- **NPI:** 1144162835 (Entity type: Organization)
- **Enumerated:** April 9, 2026
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Brian Mangenje, OWNER / NP / PROVIDER
## Practice location
- **Address:** 625 KENMOOR AVE SE # 150434, Grand Rapids, MI 49546-2395
- **Phone:** (248) 413-5013
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 9, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1144162835) · Data from the CMS NPPES public registry.