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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