HEALTHY LIVES (NPI# 1477067262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477067262 |
| Entity Type | Organization |
| Organization Name | HEALTHY LIVES |
| Practice Address |
1504 Joh Ave Ste 120 Baltimore MD 21227-1070 |
| Mailing Address |
2323 Barclay St Baltimore MD 21218-5334 |
| Practice Telephone | 4432197901 |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2019-10-07 |
| Authorized Official Name | AHMEIN WATSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4437223116 |
| Authorized Official Credential | LCSW-C, LCADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6305 Belair Rd Ste 2, Baltimore, MD 212061817 | 4432197901 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | HEALTHY LIVES | 73 Main St, Montpelier, VT 05602 |
| Street Address |
1504 JOH AVE STE 120 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21227-1070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588938237 | Ahmein Watson | Social Worker | 1504 Joh Ave Ste 120, Baltimore, MD 21227 | 2012-02-28 |
| 1679171052 | Healthy Lives, LLC | Community/Behavioral Health | 1504 Joh Ave Ste 120, Baltimore, MD 21227-1070 | 2020-10-16 |
| 1477150811 | Healthy Lives, LLC | Community/Behavioral Health | 1504 Joh Ave Ste 120, Baltimore, MD 21227-1070 | 2020-10-08 |
| 1841704533 | Healthy Lives, LLC | Clinic/Center | 1504 Joh Ave Ste 120, Baltimore, MD 21227-1070 | 2017-11-17 |
| 1366827073 | Healthy Lives, LLC | Community/Behavioral Health | 1504 Joh Ave Ste 120, Baltimore, MD 21227-1070 | 2015-07-23 |
| 1174905640 | Healthy Lives, LLC | Social Worker | 1504 Joh Ave Ste 120, Baltimore, MD 21227-1070 | 2015-06-22 |
| 1114268661 | Healthy Lives, LLC | Social Worker | 1504 Joh Ave Ste 120, Baltimore, MD 21227-1070 | 2013-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528622024 | Kim Conaway | Counselor | Regenerations Counseling Services, 1421 S. Canton Street, Baltimore, MD 21227 | 2019-04-30 |
| 1861974891 | Joan Lynn Indilisano | Occupational Therapist | 3320 Benson Avenue, Baltimore, MD 21227 | 2018-09-06 |
| 1821593161 | Institute for Dermatopathology, Inc. | Clinical Medical Laboratory | 1901 Sulphur Spring Rd Ste A, Baltimore, MD 21227 | 2018-03-28 |
| 1447779699 | Aja Williams | Registered Nurse | 3902 Annapolis Rd., Halethorpe, MD 21227 | 2017-09-19 |
| 1588190748 | Mentor-maryland | Community/Behavioral Health | 1540 Caton Center Drive, Halethorpe, MD 21227 | 2017-05-10 |
| 1083084180 | Institute for Family Centered Services | Community/Behavioral Health | 1540 Caton Centered Drive, Suite F, Baltimore, MD 21227 | 2015-10-01 |
| 1174913677 | Wye Oak Clinic, Inc. | Marriage & Family Therapist | 1937 Lansdowne Rd, Halethorpe, MD 21227 | 2015-02-04 |
| 1336442656 | Norah Orise Osian | Pharmacist | Rite Aid Pharmacy, 1400 Sulphur Spring Rd, Baltimore, MD 21227 | 2010-12-08 |
| 1366759623 | Een J Lee | Pharmacist | 1400 Sulphurspring Rd, Baltimore, MD 21227 | 2010-09-08 |
| 1780904847 | Emnet T Kflu | Counselor | 908 Francis Avenue, Halethorpe, MD 21227 | 2010-06-10 |
| Find all providers in zip 21227 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808050 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 10 S Broadway, Baltimore, MD 21231-1775 | 2020-10-12 |
| 1396343414 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 15 S Broadway, Baltimore, MD 21231-1714 | 2020-10-12 |
| 1457968984 | Powell Recovery Center | Substance Abuse Rehabilitation Facility | 22 S Broadway, Baltimore, MD 21231-1711 | 2020-09-29 |
| 1356956676 | The Elysian Fields Optimum Wellness and Mental Health Group, LLC | Substance Abuse Rehabilitation Facility | 2901 Erdman Ave, Baltimore, MD 21213-1139 | 2020-09-14 |
| 1134731284 | Serenity Keepers of Maryland LLC | Substance Abuse Rehabilitation Facility | 3645 Cottage Ave, Baltimore, MD 21215-7725 | 2020-08-20 |
| 1447875216 | Unlimited Bounds Human Services LLC | Substance Abuse Rehabilitation Facility | 504 Beaumont Ave, Baltimore, MD 21212-4310 | 2020-06-08 |
| 1417577966 | Royal Minds Inc | Substance Abuse Rehabilitation Facility | 928 W Franklin St, Baltimore, MD 21223-1337 | 2020-04-24 |
| 1912527722 | Royal Minds Inc | Substance Abuse Rehabilitation Facility | 533 Chateau Ave, Baltimore, MD 21212-4306 | 2020-04-22 |
| 1841829892 | Cmds Residential | Substance Abuse Rehabilitation Facility | 15 S Fulton Ave, Baltimore, MD 21223-2306 | 2020-04-02 |
| 1306472964 | Created for Greater Health Systems | Substance Abuse Rehabilitation Facility | 1508 N Caroline St, Baltimore, MD 21213-2804 | 2020-03-16 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.