| Changing Lives At Home Inc | |
|
4805 Garrison Blvd Baltimore MD 21215-5695 | |
| (443) 869-2600 | |
| Not Available |
| Full Name | Changing Lives At Home Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4805 Garrison Blvd, Baltimore, Maryland |
| Authorized Official Name and Position | Latrill Waizette Bryant Bass (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4434639523 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Lives At Home Inc 3606 Belle Ave Baltimore MD 21215-6102 Ph: (443) 463-9523 | Changing Lives At Home Inc 4805 Garrison Blvd Baltimore MD 21215-5695 Ph: (443) 869-2600 |
| NPI Number | 1699150144 |
|---|---|
| Provider Enumeration Date | 07/27/2015 |
| Last Update Date | 07/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699150144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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