Anew Inspired Change Organization

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ANEW INSPIRED CHANGE ORGANIZATION

Practice address

1400 Mercantile LN Ste 246
Upper Marlboro, MD 20774-5353

Phone

(301) 971-2639

Fax

(301) 386-5262

NPI assigned

Apr 26, 2018

Organization subpart

No

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

Authorized official

Name

Porshia Everett

Title

Director

Phone

(301) 971-2639

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1790273522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN STE 246",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745353",
            "telephone_number": "301-971-2639",
            "fax_number": "301-386-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN STE 246",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745353",
            "telephone_number": "301-971-2639",
            "fax_number": "301-386-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANEW INSPIRED CHANGE ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "PORSHIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-971-2639"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.