NPIMap

Organization Active NPI

180 Degree Change Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1093472961
Registry record updated Nov 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
180 DEGREE CHANGE BEHAVIORAL HEALTH LLC
Practice address
1420 Joh Ave Ste D
Baltimore, MD 21227-1073
Phone
(443) 435-0030
NPI assigned
Nov 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Latisha Flanigan
Title
Ceo
Phone
(443) 435-0030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1420 Joh Ave Ste D
Baltimore, MD 21227-1073

Mailing address

1420 Joh Ave Ste D
Baltimore, MD 21227-1073
Phone (443) 435-0030

National Provider Directory

National Provider Directory
Tax ID family
180 Degree Change Behavioral Health LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637884800000",
    "number": "1093472961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 JOH AVE STE D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271073",
            "telephone_number": "443-435-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 JOH AVE STE D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271073",
            "telephone_number": "443-435-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "180 DEGREE CHANGE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-26",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "FLANIGAN",
        "authorized_official_first_name": "LATISHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-435-0030"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.