MEDICARE: PRINCE HEALTHCARE SERVICES 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	:	1841853645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCE HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	8000 JUMPERS HOLE RD STE 15&16
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1036
Country	:	US
Telephone Number	:	443-795-4334
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 JUMPERS HOLE RD STE 15&16
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1036
Country	:	US
Telephone Number	:	443-795-4334
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. OLABOSIPO OREYOMI
Credential	:	PH.D
Telephone Number	:	443-546-9286

Provider Enumeration Date	:	04/17/2019
Last Update Date	:	02/19/2026

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Directions to “PRINCE HEALTHCARE SERVICES LLC ” Practice Location

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