NPIMap

Organization Active NPI

Impactful Changes

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1124697727
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
IMPACTFUL CHANGES
Practice address
2235 W Saratoga St
Baltimore, MD 21223-1509
Phone
(443) 473-3416
NPI assigned
Jun 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Arika Davenport
Title
Ceo
Phone
(443) 473-3416

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2235 W Saratoga St
Baltimore, MD 21223-1509

Mailing address

2235 W Saratoga St
Baltimore, MD 21223-1509
Phone (443) 473-3416

National Provider Directory

National Provider Directory
Tax ID family
Impactful Changes2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1124697727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 W SARATOGA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231509",
            "telephone_number": "443-473-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 W SARATOGA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231509",
            "telephone_number": "443-473-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACTFUL CHANGES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "ARIKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-473-3416"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "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 Sep 6, 2023; 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.