Healthcare Provider Details
I. General information
NPI: 1326929746
Provider Name (Legal Business Name): RESOLUTION HEALTH AND WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1401 S EDGEWOOD ST STE 100
HALETHORPE MD
21227-1145
US
IV. Provider business mailing address
PO BOX 2531
ELLICOTT CITY MD
21041-2531
US
V. Phone/Fax
- Phone: 443-803-3291
- Fax:
- Phone: 410-275-0968
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ODIANOSEN
OKOJIE
Title or Position: CEO
Credential:
Phone: 410-275-0928