| Change Reaction Baltimore | |
|
1111 Park Ave Ste L111 Baltimore MD 21201-5695 | |
| (443) 204-3181 | |
| Not Available |
| Full Name | Change Reaction Baltimore |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1111 Park Ave Ste L111, Baltimore, Maryland |
| Authorized Official Name and Position | Davon Newton (OWNER) |
| Authorized Official Contact | 4432043181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change Reaction Baltimore 1111 Park Ave Ste L111 Baltimore MD 21201-5695 Ph: (443) 204-3181 | Change Reaction Baltimore 1111 Park Ave Ste L111 Baltimore MD 21201-5695 Ph: (443) 204-3181 |
| NPI Number | 1760102685 |
|---|---|
| Provider Enumeration Date | 08/31/2022 |
| Last Update Date | 03/27/2024 |
| Certification Date | 03/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760102685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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