| Impact Lives Health Services, Llc | |
|
1045 Taylor Ave Ste 206 Towson MD 21286-8316 | |
| (410) 650-2771 | |
| Not Available |
| Full Name | Impact Lives Health Services, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1045 Taylor Ave Ste 206, Towson, Maryland |
| Authorized Official Name and Position | Michael Westbrook (OWNER) |
| Authorized Official Contact | 4109632602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Lives Health Services, Llc Po Box 11462 Baltimore MD 21239-0462 Ph: (410) 963-2602 | Impact Lives Health Services, Llc 1045 Taylor Ave Ste 206 Towson MD 21286-8316 Ph: (410) 650-2771 |
| NPI Number | 1194486407 |
|---|---|
| Provider Enumeration Date | 01/08/2022 |
| Last Update Date | 09/29/2022 |
| Certification Date | 09/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194486407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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