Healthcare Provider Details

I. General information

NPI: 1871233460
Provider Name (Legal Business Name): ITOJU HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W OSTEND ST STE 504&600
BALTIMORE MD
21230-3764
US

IV. Provider business mailing address

145 W OSTEND ST STE 504&600
BALTIMORE MD
21230-3764
US

V. Phone/Fax

Practice location:
  • Phone: 410-505-0419
  • Fax:
Mailing address:
  • Phone: 443-960-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KEHINDE OLAMOYEGUN
Title or Position: CEO
Credential:
Phone: 410-505-0419