NPIMap

Organization Active NPI

Enriching Lives Support Services Inc

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1184516494
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
ENRICHING LIVES SUPPORT SERVICES INC
Practice address
5109 York Rd
Baltimore, MD 21212-4399
Phone
(443) 332-5777
Fax
(443) 773-4504
NPI assigned
Jul 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Authorized official

Name
Jaquisa Nash, ADT
Title
Ceo
Phone
(443) 593-9415

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

5109 York Rd
Baltimore, MD 21212-4399

Mailing address

4925 Belair Rd
Baltimore, MD 21206-5648
Phone (443) 332-5777

Other practice location 1

4925 Belair Rd
Baltimore, MD 21206-5648
Phone (443) 332-5777

National Provider Directory

National Provider Directory
Tax ID family
Enriching Lives Support Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1753056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1184516494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065648",
            "telephone_number": "443-332-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124399",
            "telephone_number": "443-332-5777",
            "fax_number": "443-773-4504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4925 Belair Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212065648",
            "country_code": "US",
            "telephone_number": "443-332-5777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENRICHING LIVES SUPPORT SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-21",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A",
        "authorized_official_last_name": "NASH",
        "authorized_official_first_name": "JAQUISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-593-9415",
        "authorized_official_credential": "ADT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "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 Feb 9, 2026; 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.