Provider Demographics
NPI:1114484169
Name:MAKE A DIFFERENCE EVERYWHERE LLC
Entity Type:Organization
Organization Name:MAKE A DIFFERENCE EVERYWHERE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAKEETA
Authorized Official - Middle Name:NACOLE
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-546-8253
Mailing Address - Street 1:614 ANNABEL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MD
Mailing Address - Zip Code:21225-1913
Mailing Address - Country:US
Mailing Address - Phone:443-546-8253
Mailing Address - Fax:
Practice Address - Street 1:1215 ARGYLE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-2928
Practice Address - Country:US
Practice Address - Phone:443-546-8253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty