Healthcare Provider Details

I. General information

NPI: 1710837489
Provider Name (Legal Business Name): LIVING FAITH HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5502 1/2 PARK HEIGHTS AVE
BALTIMORE MD
21215-4624
US

IV. Provider business mailing address

5502 1/2 PARK HEIGHTS AVE
BALTIMORE MD
21215-4624
US

V. Phone/Fax

Practice location:
  • Phone: 301-820-5593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUNDAY OGUNDIPE
Title or Position: CEO
Credential:
Phone: 301-820-5593