Changing Lives at Home Sud,Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHANGING LIVES AT HOME SUD,INC

Practice address

4805 Garrison Blvd
1St Floor and Suite 200
Baltimore, MD 21215-5695

Phone

(443) 869-2600

Fax

(410) 510-1982

NPI assigned

Jun 28, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Latrill Bryant-BassNPI 1417804436

Title

Ceo/Director

Phone

(443) 463-9523

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latrill Bryant-Bass, LMSW

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1417804436
  NPD Authorized official

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1124705546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 GLENN ELLEN CIR",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081028",
            "telephone_number": "443-463-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 GARRISON BLVD",
            "address_2": "1ST FLOOR AND SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155695",
            "telephone_number": "443-869-2600",
            "fax_number": "410-510-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING LIVES AT HOME SUD,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "BRYANT-BASS",
        "authorized_official_first_name": "LATRILL",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "443-463-9523",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Changing Faces Health and Therapeutic Services Inc
• Changing Lives at Home Inc Mental Health
• Changing Lives at Home Mental Health Corporation
• Changing Lives at Home Mental Health Corporation
• Changing Lives at Home Mental Health Services,Inc
• Changing Lives at Home, Inc. Mental Health
• Changing Lives Together, LLC
• Changing Perspectives LLC
• Changing Perspectives SLT LLC
• Changing Turn Community Healthcare Services

• Community/Behavioral Health Agency in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.