NPIMap

Organization Active NPI

Impact Lives Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1326710443
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
IMPACT LIVES HEALTH SERVICES, LLC
Practice address
1045 Taylor Ave Ste 206
Baltimore, MD 21286-8316
Phone
(443) 963-2602
NPI assigned
Sep 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Ariel Westbrook
Title
C.E.O.
Phone
(443) 473-4049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1045 Taylor Ave Ste 206
Baltimore, MD 21286-8316

Mailing address

PO Box 11462
Baltimore, MD 21239-0462
Phone (410) 963-2602

Other names 1

  • Impact lives health service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Impact Lives Health Services LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1326710443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11462",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212390462",
            "telephone_number": "410-963-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 TAYLOR AVE STE 206",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212868316",
            "telephone_number": "443-963-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT LIVES HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "WESTBROOK",
        "authorized_official_first_name": "ARIEL",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "443-473-4049"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact lives health service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 14, 2025; 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.