| Change Health Systems, Inc | |
|
2401 Liberty Heights Ave Suite 4670 Baltimore MD 21215-8019 | |
| (410) 233-1088 | |
| (410) 233-1087 |
| Full Name | Change Health Systems, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2401 Liberty Heights Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Israel Ojo (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4102331088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change Health Systems, Inc 2401 Liberty Heights Ave Suite 4670 Baltimore MD 21215-8019 Ph: (410) 233-1088 | Change Health Systems, Inc 2401 Liberty Heights Ave Suite 4670 Baltimore MD 21215-8019 Ph: (410) 233-1088 |
| NPI Number | 1750428470 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 03/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750428470 | NPI | - | NPPES |
| 410166900 | Medicaid | MD | |
| 404096100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 11925 (Maryland) | Primary |
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