Organization
CHANGING LIVES AT HOME SUD,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATRILL BRYANT-BASS (CEO/DIRECTOR)
(443) 463-9523
Entity
Organization
Contact information
Practice address
4805 GARRISON BLVD, 1ST FLOOR AND SUITE 200, BALTIMORE, MD 21215-5695
(443) 869-2600
(410) 510-1982
Mailing address
202 GLENN ELLEN CIR, PIKESVILLE, MD 21208-1028
(443) 463-9523
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
06/30/2023
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