Healthcare Provider Details

I. General information

NPI: 1801378435
Provider Name (Legal Business Name): SAVING LIVES CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HILLCREST DR STE A101
FREDERICK MD
21703-6105
US

IV. Provider business mailing address

3 HILLCREST DR STE A101
FREDERICK MD
21703-6105
US

V. Phone/Fax

Practice location:
  • Phone: 240-575-9940
  • Fax: 240-575-9481
Mailing address:
  • Phone: 240-575-9940
  • Fax: 240-575-9481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR191391
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. OLUWAKEMI OSIDELE
Title or Position: CEO
Credential: DNP, FNP-C
Phone: 240-277-3768