Healthcare Provider Details

I. General information

NPI: 1902582505
Provider Name (Legal Business Name): SCEPTER HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 DURHAM WAY
HANOVER MD
21076
US

IV. Provider business mailing address

7661 ARUNDEL MILLS BLVD # 1017
HANOVER MD
21076-1305
US

V. Phone/Fax

Practice location:
  • Phone: 410-499-6686
  • Fax:
Mailing address:
  • Phone: 410-499-6686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KEHINDE LANIYI
Title or Position: PRESIDENT
Credential:
Phone: 410-499-6686