Healthcare Provider Details

I. General information

NPI: 1457283038
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHIATRIC AND ADDICTION REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3034 MITCHELLVILLE RD
BOWIE MD
20716-1388
US

IV. Provider business mailing address

3500 KIDDER RD
CLINTON MD
20735-4594
US

V. Phone/Fax

Practice location:
  • Phone: 202-704-1090
  • Fax:
Mailing address:
  • Phone: 202-704-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPHUS IDOWU
Title or Position: COO
Credential:
Phone: 202-704-1090