CHANGING LIVES ADULT & YOUTH SERVICES (NPI# 1902241250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902241250 |
| Entity Type | Organization |
| Organization Name | CHANGING LIVES ADULT & YOUTH SERVICES |
| Practice Address |
4810 Saint Barnabas Rd Ste 203 Temple Hills MD 20748-4604 |
| Practice Telephone | 2024315576 |
| Mailing Telephone | 3015410963 |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2019-09-10 |
| Authorized Official Name | MR. SYDNEY BASKINS (CEO) |
| Authorized Official Telephone | 3015410963 |
| Authorized Official Credential | B.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 1609320340 | 05 | |
| MD | 1902241250 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609320340 | Changing Lives Adult & Youth Services | Case Management | 9015 Woodyard Rd Ste 109, Clinton, MD 20735-4226 | 2016-08-11 |
| Street Address |
4810 SAINT BARNABAS RD STE 203 |
| City | TEMPLE HILLS |
| State | MD |
| Zip Code | 20748-4604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316579873 | Brightway Professionals and Associates | Clinic/Center | 4810 St.barnabas Rd, Suite 201, Temple Hills, MD 20748 | 2020-02-12 |
| 1235783085 | Jasmine Lenee Carter | Behavior Technician | 5506 Clothier St., Temple Hills, MD 20748 | 2019-07-30 |
| 1649760075 | Livewell Family Clinic LLC | Clinic/Center | 3611 Branch Ave Ste 404, Temple Hills, MD 20748 | 2018-05-10 |
| 1346785474 | Cardinal Health Care Solution LLC | Home Health | 4905 Faith Crossin Ct, Templehills, MD 20748 | 2016-12-28 |
| 1205370095 | Crystal Hughes | Specialist | 6337 Old Branch Ave Shop 37, Camp Springs, MD 20748 | 2016-12-13 |
| 1417385444 | Ibhs LLC | Substance Abuse Rehabilitation Facility | 5000 Barnabas Road, Ct2, Temple Hills, MD 20748 | 2013-10-30 |
| 1063848703 | Oluwagbenga Jegede | Home Health Aide | 6516 Allentown Rd, Temple Hills, MD 20748 | 2013-09-25 |
| 1184067514 | Vijaya Lakshmi Alla | Family Medicine | 6014 Old Branch Avenue, Temple Hills, MD 20748 | 2013-04-16 |
| 1215178959 | Patricia Ann Carter | Counselor | 5121 Henderson Road, Suite 101, Temple Hills, MD 20748 | 2009-03-10 |
| 1427220888 | Emerging Vision | Technician/Technologist | 3801 D Branch Ave, Iverson Mall, Temple Hills, MD 20748 | 2008-03-26 |
| Find all providers in zip 20748 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1972102309 | Arise & Shine Health Center LLC | Clinic/Center | 2301 Dorsey Rd Ste 208, Glen Burnie, MD 21061-3275 | 2020-10-17 |
| 1942807987 | Ray of Hope Counseling Center LLC | Clinic/Center | 48 Wedge Way, Pikesville, MD 21208-1210 | 2020-10-02 |
| 1255948642 | Apple Tree Wellness | Clinic/Center | 119 Teachers Way Apt 3044, Gaithersburg, MD 20877-3176 | 2020-09-29 |
| 1154938975 | Lovework, LLC | Clinic/Center | 2352 Eutaw Pl Apt 3, Baltimore, MD 21217-4084 | 2020-09-25 |
| 1144837980 | King Health Systems, Inc. | Clinic/Center | 14201 Laurel Park Dr Ste 206, Laurel, MD 20707-5203 | 2020-09-25 |
| 1871109181 | Journey Health Center | Clinic/Center | 1808 Woodlawn Dr Ste O, Gwynn Oak, MD 21207-4023 | 2020-09-22 |
| 1801402656 | Desicare LLC | Clinic/Center | 7712 West Shore Road, Pasadena, MD 21122-1519 | 2020-09-17 |
| 1508472226 | Resilient Psychiatry, LLC | Clinic/Center | 744 Dulaney Valley Rd Ste 7, Towson, MD 21204-5132 | 2020-09-17 |
| 1356955298 | Peace In Perspective | Clinic/Center | 11 Far Corners Loop, Sparks, MD 21152-9256 | 2020-09-08 |
| Find all providers with the same taxonomy | ||||
| City | TEMPLE HILLS |
| Zip Code | 20748 |
Please comment or provide details below to improve the information on CHANGING LIVES ADULT & YOUTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.