Organization
INSPIRING CHANGE MENTAL HEALTH SERVICES, LLC.
Active
Parent organization
INSPIRING CHANGE MENTAL HEALTH SERVICES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INSPIRING CHANGE MENTAL HEALTH SERVICES, LLC
Authorized official
SHAQUANNA FOSTER-DOTSON (CEO)
(410) 258-6714
Entity
Organization
Contact information
Practice address
4654 YORK RD # 1A, BALTIMORE, MD 21212-4726
(410) 258-6714
Mailing address
PO BOX 7036, BALTIMORE, MD 21216-0036
(410) 258-6714
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
10/22/2019
Last updated
08/12/2021
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