Healthcare Provider Details

I. General information

NPI: 1962229112
Provider Name (Legal Business Name): ESNO HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 EXECUTIVE DR STE 110-112
CATONSVILLE MD
21228-1766
US

IV. Provider business mailing address

8115 MAPLE LAWN BLVD STE 350
FULTON MD
20759-2683
US

V. Phone/Fax

Practice location:
  • Phone: 410-595-5980
  • Fax: 541-314-9497
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: OBINNA OBIEJEMBA
Title or Position: OWNER
Credential:
Phone: 410-800-3440