| Changing Lives At Home, Inc. Mental Health | |
|
4805 Garrison Blvd Baltimore MD 21215-5695 | |
| (443) 463-9523 | |
| Not Available |
| Full Name | Changing Lives At Home, Inc. Mental Health |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4805 Garrison Blvd, Baltimore, Maryland |
| Authorized Official Name and Position | Latrill Waizette Bryant-bass (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. Mental Health 3606 Belle Ave Baltimore MD 21215-6102 Ph: (443) 463-9523 | Changing Lives At Home, Inc. Mental Health 4805 Garrison Blvd Baltimore MD 21215-5695 Ph: (443) 463-9523 |
| NPI Number | 1740611623 |
|---|---|
| Provider Enumeration Date | 12/03/2013 |
| Last Update Date | 06/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740611623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Maryland) | Primary |
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