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Organization
CHANGING LIFE MENTAL HEALTH BEHAVIORAL LLC
Active
Organization
CHANGING LIFE MENTAL HEALTH BEHAVIORAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATU KOROMA NP (OWNER)
(240) 437-2705
Entity
Organization
Contact information
Practice address
6490 LANDOVER RD STE C9, CHEVERLY, MD 20785-1443
(240) 437-2705
Mailing address
106 CALUMET CT, GAMBRILLS, MD 21054-1060
(240) 437-2705
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/04/2025
Last updated
07/04/2025
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