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180 Degree Change Behavioral Health LLC

Community/Behavioral Health in Baltimore, MD. Organization (NPI-2).

NPI number1336805613
StatusActive
Last updated in NPPESNov 11, 2021

Details

NPI
1336805613
Entity type
Organization (NPI-2)
Legal business name
180 Degree Change Behavioral Health LLC
Organization subpart
No
Enumeration date
Nov 11, 2021
Certification date
Nov 11, 2021
Last updated
Nov 11, 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

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