Organization
HOUSE OF CHANGE BEHAVIORAL HEALTH CENTER
Active
Parent organization
HOUSE OF CHANGE BEHAVIORAL HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOUSE OF CHANGE BEHAVIORAL HEALTH CENTER
Authorized official
VANESSA LYLE (BILLING SPECIALIST)
(410) 500-0712
Entity
Organization
Contact information
Practice address
1533 EDMONDSON AVE, BALTIMORE, MD 21223-1206
(410) 323-3500
(410) 323-3544
Mailing address
5209 YORK RD STE B6, BALTIMORE, MD 21212-4247
(410) 323-3500
(410) 323-3544
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH001446
BEHAV HEALTH LICENSE
MD
Enumeration date
01/04/2019
Last updated
01/04/2019
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