Provider Demographics
NPI:1235936915
Name:TRI NUE CHANGING LIVES
Entity type:Organization
Organization Name:TRI NUE CHANGING LIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEVENA
Authorized Official - Middle Name:
Authorized Official - Last Name:OFFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:443-301-2389
Mailing Address - Street 1:7747 SPENCER RD
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8241
Mailing Address - Country:US
Mailing Address - Phone:443-301-2389
Mailing Address - Fax:
Practice Address - Street 1:6210 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3425
Practice Address - Country:US
Practice Address - Phone:443-301-2389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty