Organization
BUILDING LIVES ON COMMUNITY KINDNESS & STEWARDSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QWAN NEEDUM (CEO)
(410) 262-4822
Entity
Organization
Contact information
Practice address
3706 GREENMOUNT AVE, BALTIMORE, MD 21218-1843
(410) 262-4822
Mailing address
3706 GREENMOUNT AVE, BALTIMORE, MD 21218-1843
(141) 036-6305
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
919255
—
MD
01
—
LC7575
LICENSED CLINICAL PROFESSIONAL COUNSELOR
MD
Enumeration date
03/16/2021
Last updated
01/08/2022
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