Organization
IMPACT LIVES HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WESTBROOK (OWNER)
(410) 963-2602
Entity
Organization
Contact information
Practice address
1045 TAYLOR AVE, TOWSON, MD 21286-8331
(410) 650-2771
Mailing address
PO BOX 11462, BALTIMORE, MD 21239-0462
(410) 410-9632
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/08/2022
Last updated
09/29/2022
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