Healthcare Provider Details

I. General information

NPI: 1700734423
Provider Name (Legal Business Name): BUILT TO WIN BY FAITH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6817 OLD BRANCH AVE
TEMPLE HILLS MD
20748-6905
US

IV. Provider business mailing address

6817 OLD BRANCH AVE
TEMPLE HILLS MD
20748-6905
US

V. Phone/Fax

Practice location:
  • Phone: 240-734-3467
  • Fax: 301-238-7849
Mailing address:
  • Phone: 240-734-3467
  • Fax: 301-238-7849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LATIVIA SHANTE BROWN
Title or Position: CLINICAL DIRECTOR
Credential: LCPC
Phone: 240-702-8168