NPIMap

Organization Active NPI

Impact Lives Health Services, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Towson, MD
National Provider Identifier
1639830946
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
IMPACT LIVES HEALTH SERVICES, LLC
Practice address
1045 Taylor Ave
Towson, MD 21286-8331
Phone
(410) 650-2771
NPI assigned
Jan 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Authorized official

Name
Michael Westbrook
Title
Owner
Phone
(410) 963-2602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1045 Taylor Ave
Towson, MD 21286-8331

Mailing address

PO Box 11462
Baltimore, MD 21239-0462
Phone (410) 410-9632

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL michael@impactliveshealthservices.com Direct

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": "1641600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1639830946",
    "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": "410-410-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 TAYLOR AVE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868331",
            "telephone_number": "410-650-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT LIVES HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-08",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "WESTBROOK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-963-2602"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "michael@impactliveshealthservices.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1055 Taylor Ave",
            "city": "Towson",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212868317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.