Provider Demographics
NPI: | 1487414975 |
---|---|
Name: | LIFTING STIGMAS AND CHANGING LIVES |
Entity type: | Organization |
Organization Name: | LIFTING STIGMAS AND CHANGING LIVES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | NURA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HILL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 410-802-0373 |
Mailing Address - Street 1: | 7904 HARFORD RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PARKVILLE |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21234-5816 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 410-802-0373 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7904 HARFORD RD |
Practice Address - Street 2: | |
Practice Address - City: | PARKVILLE |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21234-5816 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-802-0373 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-03-20 |
Last Update Date: | 2024-03-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No | 251J00000X | Agencies | Nursing Care | |
No | 251S00000X | Agencies | Community/Behavioral Health | |
No | 252Y00000X | Agencies | Early Intervention Provider Agency | |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
No | 261QP0905X | Ambulatory Health Care Facilities | Clinic/Center | Public Health, State or Local |
No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No | 261QP3300X | Ambulatory Health Care Facilities | Clinic/Center | Pain |
No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness |