Provider Demographics
NPI:1891188439
Name:CHANGING TURN COMMUNITY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:CHANGING TURN COMMUNITY HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAUNNA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-402-0172
Mailing Address - Street 1:5438 YORK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3842
Mailing Address - Country:US
Mailing Address - Phone:443-708-1461
Mailing Address - Fax:443-708-1655
Practice Address - Street 1:3006 HAMILTON AVE STE 103
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2634
Practice Address - Country:US
Practice Address - Phone:443-708-1461
Practice Address - Fax:443-708-1655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMH-1043251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD109103400Medicaid