Life Connection Behavioral Health Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIFE CONNECTION BEHAVIORAL HEALTH SERVICES, LLC

Practice address

1515 Martin Blvd Ste 206
Middle River, MD 21220-4103

Phone

(410) 365-1293

NPI assigned

Aug 1, 2021

Last updated

Aug 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Torone Samuels

Title

Ceo

Phone

(410) 365-1293

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627776000000",
    "number": "1194498493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WALNUT GROVE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212216061",
            "telephone_number": "410-365-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MARTIN BLVD STE 206",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212204103",
            "telephone_number": "410-365-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CONNECTION BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-01",
        "last_updated": "2021-08-01",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "TORONE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-365-1293",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Middle River, 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 Aug 1, 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.