Healthcare Provider Details

I. General information

NPI: 1821893603
Provider Name (Legal Business Name): LIBENTIA HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MERCANTILE LN STE 203
LARGO MD
20774-5341
US

IV. Provider business mailing address

1400 MERCANTILE LN STE 203
LARGO MD
20774-5341
US

V. Phone/Fax

Practice location:
  • Phone: 240-459-6084
  • Fax: 240-366-6783
Mailing address:
  • Phone: 240-459-6084
  • Fax: 240-366-6783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HALIMAT AKOJIE
Title or Position: OWNER
Credential: DNP
Phone: 240-459-6084