Healthcare Provider Details

I. General information

NPI: 1285578187
Provider Name (Legal Business Name): ELEMENT OF CHANGE HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6214 REISTERSTOWN RD
BALTIMORE MD
21215-3425
US

IV. Provider business mailing address

7426 MAURY RD
WINDSOR MILL MD
21244-4009
US

V. Phone/Fax

Practice location:
  • Phone: 443-876-4951
  • Fax:
Mailing address:
  • Phone: 443-876-4951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: JEREX ASHU
Title or Position: OWNER/CEO
Credential:
Phone: 443-876-4951