MEDICARE: CHANGING TURNS WITH TEAM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1710621115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANGING TURNS WITH TEAM LLC

Provider Business Mailing Address
First Line	:	1715 GWYNN OAK AVE
Second Line	:
City	:	GWYNN OAK
State	:	MD
Zip	:	21207-5280
Country	:	US
Telephone Number	:	443-314-8564
Fax Number	:

Provider Business Practice Location Address
First Line	:	3270 NORTH BEND RD STE 209
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-7611
Country	:	US
Telephone Number	:	443-314-8564
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	ARIEL ADAMS
Credential	:	LCPC
Telephone Number	:	443-314-8564

Provider Enumeration Date	:	04/22/2022
Last Update Date	:	04/25/2022

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