NPIMap

Organization Active NPI

Changing Lives at Home Mental Health Corporation

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1710491287
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHANGING LIVES AT HOME MENTAL HEALTH CORPORATION
Practice address
4805 Garrison Blvd
1St Floor and Suite 200
Baltimore, MD 21215-5695
Phone
(443) 869-2600
NPI assigned
Nov 20, 2017
Reactivated
Jul 10, 2023
Last updated
Aug 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Authorized official

Name
Latrill Bryant-BassNPI 1417804436
Title
Director
Phone
(443) 869-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MD Primary

Addresses

Primary practice location

4805 Garrison Blvd
1St Floor and Suite 200
Baltimore, MD 21215-5695

Mailing address

202 Glenn Ellen Cir
Pikesville, MD 21208-1028
Phone (443) 463-9523

Other names 1

  • Changing Lives Home SUD Other name

National Provider Directory

National Provider Directory
Tax ID family
Changing Lives at Home Mental Health Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1710491287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 GLENN ELLEN CIR",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081028",
            "telephone_number": "443-463-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 GARRISON BLVD",
            "address_2": "1ST FLOOR AND SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155695",
            "telephone_number": "443-869-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING LIVES AT HOME MENTAL HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "deactivation_date": "2023-05-22",
        "reactivation_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "BRYANT-BASS",
        "authorized_official_first_name": "LATRILL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-869-2600"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Changing Lives Home SUD",
            "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 Aug 2, 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.