Healthcare Provider Details

I. General information

NPI: 1962215020
Provider Name (Legal Business Name): CHARITY HEALTHCARE AND CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 MEDICAL CENTER DR STE 262
LARGO MD
20774-3709
US

IV. Provider business mailing address

2200 OLD LARGO RD
KETTERING MD
20774-8589
US

V. Phone/Fax

Practice location:
  • Phone: 240-441-6378
  • Fax:
Mailing address:
  • Phone: 202-635-5756
  • Fax: 662-214-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: URSULA AKEM
Title or Position: CEO
Credential:
Phone: 202-635-5756