Healthcare Provider Details

I. General information

NPI: 1770176513
Provider Name (Legal Business Name): ALTRUISTIC HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 BALTIMORE NATIONAL PIKE STE 250B
CATONSVILLE MD
21228-3947
US

IV. Provider business mailing address

6400 BALTIMORE NATIONAL PIKE STE 250B
CATONSVILLE MD
21228-3947
US

V. Phone/Fax

Practice location:
  • Phone: 443-251-2966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADEYINKA WINDAPO
Title or Position: ADMINSTRATOR
Credential:
Phone: 443-251-2966