NPIMap

Organization Active NPI

Life Enhancement Services of MD, LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1366015455
Registry record updated Feb 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIFE ENHANCEMENT SERVICES OF MD, LLC
Practice address
6340 Security Blvd Ste 100
Baltimore, MD 21207-5173
Phone
(202) 269-2401
NPI assigned
Jul 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2023

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

Authorized official

Name
Mr. Herbert Gray III
Title
Ceo
Phone
(202) 269-2401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

6340 Security Blvd Ste 100
Baltimore, MD 21207-5173

Mailing address

1818 New York Ave NE Ste 115
Washington, DC 20002-1851
Phone (202) 269-2401

Other names 1

  • Life Enhancement Services Maryland Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cstewart@lesdc.org Direct

National Provider Directory

National Provider Directory
Tax ID family
Life Enhancement Services23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677369600000",
    "number": "1366015455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 NEW YORK AVE NE STE 115",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021851",
            "telephone_number": "202-269-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212075173",
            "telephone_number": "202-269-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ENHANCEMENT SERVICES OF MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-269-2401",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cstewart@lesdc.org",
            "affiliation": "N",
            "endpointDescription": "cstewart@lesdc.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "6340 Security Blvd Ste 100",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212075173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Enhancement Services Maryland",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Life Enhancement Services Maryland",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 26, 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.