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CHANGING LIVES AT HOME SUD,INC
NPI 1124705546
Community/Behavioral Health in Baltimore, MD

Active since June 28, 2023
4805 GARRISON BLVD, 1ST FLOOR AND SUITE 200, BALTIMORE, MD 21215(443) 869-2600(410) 510-1982 Get Directions Write a Review

NPPES record last updated: June 30, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Changing Lives At Home Sud,inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANGING LIVES AT HOME SUD,INC (NPI 1124705546) is a healthcare organization registered as a community/behavioral health in Baltimore, Maryland and active in the NPI registry since June 2023. The organization lists Latrill Bryant-bass, Ceo/director, as its authorized official.

NPPES Registry Identity

NPI1124705546
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameCHANGING LIVES AT HOME SUD,INC
Location Address4805 GARRISON BLVD, 1ST FLOOR AND SUITE 200Baltimore, MD 21215-5695
Mailing Address202 Glenn Ellen CirPikesville, MD 21208-1028 · (443) 463-9523
Phone(443) 869-2600
Fax(410) 510-1982
Organization SubpartNo
Authorized OfficialLatrill Bryant-bassCeo/director · (443) 463-9523
Enumeration DateJune 28, 2023
Last NPPES UpdateJune 30, 2023
NPPES CertifiedJune 30, 2023
✔ NPI 1124705546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
4805 GARRISON BLVD, Baltimore, MD 21215
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKESHA WILLS
Counselor (Mental Health)
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600
NINA N ROBINSON
Counselor (Addiction (Substance Use Disorder))
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600
IVY MARINO
Rehabilitation Counselor
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600
WINDELL POWELL
Counselor (Mental Health)
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600
MS. MAMAYAA GYASI CPRP
Community/Behavioral Health
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600
KENYATTA THOMPSON
Social Worker
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600
MORGAN SHANAE KERSTETTER BA
Community Health Worker
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600
JAY GOODMAN
Community/Behavioral Health
4805 GARRISON BLVD
BALTIMORE, MD 21215
Baltimore City (443) 869-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Changing Lives At Home Sud,inc's NPI number?

The NPI number for Changing Lives At Home Sud,inc is 1124705546. It was assigned to this organization in the NPPES registry on June 28, 2023.

Where is Changing Lives At Home Sud,inc located?

Changing Lives At Home Sud,inc is located at 4805 Garrison Blvd 1st Floor And Suite 200, Baltimore, MD 21215. The listed phone number is (443) 869-2600.

What is Changing Lives At Home Sud,inc's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Changing Lives At Home Sud,inc was last updated on June 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.