Organization
CHANGING LIVES AT HOME INC MENTAL HEALTH
Active
Other names
Changing Lives at Home Inc
Organization subpart
No
Provider details
NPI number
Authorized official
LATRILL WAIZETTE BRYANT BASS MSW (EXECUTIVE DIRECTOR)
(443) 463-9523
Entity
Organization
Contact information
Practice address
4805 GARRISON BLVD, BALTIMORE, MD 21215-5695
(443) 869-2600
Mailing address
3606 BELLE AVE, BALTIMORE, MD 21215-6102
(443) 463-9523
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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