Organization · NPI-2

180 Degree Change Behavioral Health LLC

Community/Behavioral Health · Baltimore, MD

NPI number1093472961
StatusActive
Last updated in NPPESNov 26, 2021

Details

NPI
1093472961
Entity type
Organization (NPI-2)
Legal business name
180 Degree Change Behavioral Health LLC
Organization subpart
No
Enumeration date
Nov 26, 2021
Certification date
Nov 11, 2021
Last updated
Nov 26, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Practice location

1420 Joh Ave Ste D
Baltimore, MD 21227-1073

Phone 443-435-0030

Mailing address

1420 Joh Ave Ste D
Baltimore, MD 21227-1073

Phone 443-435-0030

Authorized official

Latisha Flanigan
Ceo
4434350030

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Community/Behavioral Health providers in Baltimore, MD