Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Changing Lives Wellness LLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1144162835

Changing Lives Wellness LLC is a Psychiatric/Mental Health Nurse Practitioner in Grand Rapids, Michigan. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

625 Kenmoor Ave SE # 150434
Grand Rapids, MI 49546-2395
Phone: (248) 413-5013
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1144162835
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brian Mangenje — Owner / Np / Provider · (248) 413-5013
NPI enumeratedApril 9, 2026
Last updated in NPPESApril 9, 2026
Certification dateApril 9, 2026
Mailing address625 Kenmoor Ave Se # 150434, Grand Rapids, MI 49546-2395

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