Organization
ENRICHING LIVES SUPPORT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAQUISA NASH ADT (CEO)
(443) 593-9415
Entity
Organization
Contact information
Practice address
5109 YORK RD, BALTIMORE, MD 21212-4399
(443) 332-5777
(443) 773-4504
Mailing address
4925 BELAIR RD, BALTIMORE, MD 21206-5648
(443) 332-5777
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/21/2025
Last updated
02/09/2026
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