Changing Lives Agency
NPI 1457282980ActiveOrganization· Preferred Provider Organization· Mableton, GA
Preferred Provider Organization in Mableton, Georgia, registered in NPPES in May 2026. The authorized official on file is Boniat Jemison, Owner.
Overview
| NPI | 1457282980 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 25, 2026 |
| Last updated in NPPES | May 25, 2026 |
| Certified by provider | May 25, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Preferred Provider Organization Primary | 305R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|