CHANGING LIVES AT HOME INC MENTAL HEALTH (NPI# 1699150144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699150144 |
| Entity Type | Organization |
| Organization Name | CHANGING LIVES AT HOME INC MENTAL HEALTH |
| Other Organization Name | CHANGING LIVES AT HOME INC |
| Practice Address |
4805 Garrison Blvd Baltimore MD 21215-5695 |
| Mailing Address |
3606 Belle Ave Baltimore MD 21215-6102 |
| Practice Telephone | 4438692600 |
| Mailing Telephone | 4434639523 |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |
| Authorized Official Name | LATRILL WAIZETTE BRYANT BASS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4434639523 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Changing Lives at Home Inc | Other Name - Individual/Organization |
| Street Address |
4805 GARRISON BLVD |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21215-5695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679787063 | Zachary Dean Press | Dentist | 4805 Garrison Blvd, Baltimore, MD 21215-5641 | 2007-05-09 |
| 1003469974 | Changing Lives At Home Mental Health Services,inc | Community/Behavioral Health | 4805 Garrison Blvd, Baltimore, MD 21215-5695 | 2019-07-19 |
| 1427534833 | Ashley L Collins | Social Worker | 4805 Garrison Blvd, Baltimore, MD 21215-5695 | 2018-07-18 |
| 1710491287 | Changing Lives At Home Mental Health Services,inc | Community/Behavioral Health | 4805 Garrison Blvd, Baltimore, MD 21215-5695 | 2017-11-20 |
| 1831644459 | Cardiopulmonary Services, LLC | Respiratory Therapist, Certified | 4805 Garrison Blvd, Suite 200, Baltimore, MD 21215-5695 | 2016-08-24 |
| 1912354184 | Changing Lives At Home Mental Health Services,inc | Community/Behavioral Health | 4805 Garrison Blvd, Baltimore, MD 21215-5695 | 2016-05-18 |
| 1740611623 | Changing Lives At Home, Inc. Mental Health | Community/Behavioral Health | 4805 Garrison Blvd, Baltimore, MD 21215-5695 | 2013-12-03 |
| 1992055271 | Obinna Obiejemba | Nurse Practitioner | 4805 Garrison Blvd, Baltimore, MD 21215-5695 | 2012-09-14 |
| 1841517224 | Antone Wright | Respiratory Therapist, Registered | 4805 Garrison Blvd, Suite 200, Baltimore, MD 21215-5695 | 2010-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736796 | Talal Abalkhail | Student in an Organized Health Care Education/Training Program | 2401 W. Belvedere Avenue, Baltimore, Md 21215, Baltimore, MD 21215 | 2019-05-23 |
| 1235795410 | Bilal Khan | Student in an Organized Health Care Education/Training Program | 2041 West Belvedere Avenue, Balitmore, MD 21215 | 2019-05-14 |
| 1669036067 | Nasir M Alhamdan | Student in an Organized Health Care Education/Training Program | Of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215 | 2019-05-01 |
| 1851863971 | Brittany Michelle O'neill | Specialist/Technologist | Hearing and Speech Agency, 5900 Metro Drive, Baltimore, MD 21215 | 2018-12-31 |
| 1881164432 | Emily Gamma | Social Worker | 4810 Seton Drive, Baltimore, MD 21215 | 2018-11-27 |
| 1518440478 | Benson Baby | Physical Therapist | 2525west Belveder Ave, Baltimore, MD 21215 | 2018-09-07 |
| 1609360817 | Bonnie Kahler | Clinical Nurse Specialist | 2401 Belvedere Avenue, Baltimore, MD 21215 | 2018-06-20 |
| 1932693843 | Kelley Monica Cohill | Social Worker | Sinai Hospital, Department of Psychiatry, 2440 Cylburn Ave., Baltimore, MD 21215 | 2018-06-15 |
| 1497245609 | Kimberly Beth Koerner | Social Worker | 2401 W. Belvedere Avenue, Baltimore, MD 21215 | 2018-05-14 |
| 1184113078 | Mary Jo Kozel | Registered Nurse | 2401 West Belvedere, Baltimore, MD 21215 | 2018-05-07 |
| Find all providers in zip 21215 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366043127 | Ch Mh Services (md), LLC | Community/Behavioral Health | 12 W Montgomery St Ste 107, Baltimore, MD 21230-4490 | 2020-11-06 |
| 1568062099 | Borderless Healthcare Services, LLC | Community/Behavioral Health | 1900 E Northern Pkwy Ste 308, Baltimore, MD 21239-2111 | 2020-10-26 |
| 1982211322 | Brenda Bivens Wilson | Community/Behavioral Health | 1726 Bolton St, Baltimore, MD 21217-4904 | 2020-09-29 |
| 1366056855 | The Wel Foundation, LLC. | Community/Behavioral Health | 5858 Belair Rd, Baltimore, MD 21206-2661 | 2020-09-02 |
| 1679185177 | Center for Youth and Families Inc | Community/Behavioral Health | 6304 Elinore Ave, Baltimore, MD 21206-1721 | 2020-08-18 |
| 1457977100 | Apex Wellness Group, LLC | Community/Behavioral Health | 118 E 25th St Unit 2, Baltimore, MD 21218-5281 | 2020-06-18 |
| 1922622737 | Johns Hopkins Bayview Medical Center, Inc. | Community/Behavioral Health | 5500 E. Lombard Street, Room 1025, Baltimore, MD 21224 | 2020-06-08 |
| 1669093829 | Upcoming Enterprize Corporation | Community/Behavioral Health | 6615 Reisterstown Rd Ste Ll2, Baltimore, MD 21215-2686 | 2020-04-29 |
| 1922629344 | Providing Empowerment Advocacy & Social Skills | Community/Behavioral Health | 2361 Flax Ter, Baltimore, MD 21209-4625 | 2020-04-27 |
| 1801415153 | New Life Family Services LLC | Community/Behavioral Health | 3010 Ridgewood Ave Ste 210, Baltimore, MD 21215-6211 | 2020-04-15 |
| 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.