Organization · Type 2 NPI
Change of Life
Mental Health Clinic/Center (Including Community Mental Health Center) · Indianola, MS
NPI number
1245199975
Active
Practice location
411 Roosevelt St
Indianola, MS 38751-3141
Fax (662) 452-5066
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | None listed |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
Other mental health clinic/center (including community mental health center) providers in Indianola
About NPI 1245199975
Change of Life's National Provider Identifier is 1245199975, issued on Jan 19, 2026. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Indianola, MS. The record was last updated on Jan 19, 2026.