Organization
CHANGING LIVES AT HOME, INC. MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATRILL WAIZETTE BRYANT-BASS MSW (DIRECTOR)
(443) 463-9523
Entity
Organization
Contact information
Practice address
4805 GARRISON BLVD, BALTIMORE, MD 21215-5695
(443) 463-9523
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
—
MD
Other
Enumeration date
12/03/2013
Last updated
03/11/2026
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