Healthcare Provider Details

I. General information

NPI: 1720395502
Provider Name (Legal Business Name): CHANGING TURN COMMUNITY HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 EDGEWOOD RD SUITE 210
EDGEWOOD MD
21040-2737
US

IV. Provider business mailing address

500 EDGEWOOD RD SUITE 210
EDGEWOOD MD
21040-2737
US

V. Phone/Fax

Practice location:
  • Phone: 443-402-0172
  • Fax: 443-922-7839
Mailing address:
  • Phone: 443-402-0172
  • Fax: 443-922-7839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHAUNNA THOMAS
Title or Position: CEO; PRP PROGRAM COORDINATOR
Credential:
Phone: 443-402-0172