Healthcare Provider Details

I. General information

NPI: 1538968037
Provider Name (Legal Business Name): ERIC AMANING OKOREE CAREGIVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 GREEN CRESCENT CT
GREENBELT MD
20770-3098
US

IV. Provider business mailing address

6801 GREEN CRESCENT CT
GREENBELT MD
20770-3098
US

V. Phone/Fax

Practice location:
  • Phone: 240-304-6769
  • Fax:
Mailing address:
  • Phone: 240-304-6769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberMD-10275586627
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: