Healthcare Provider Details

I. General information

NPI: 1497421804
Provider Name (Legal Business Name): HEALTHY MIND FOUNDATION AFRICA LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 07/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 SANDY SPRING RD STE 29
LAUREL MD
20707-3596
US

IV. Provider business mailing address

8101 SANDY SPRING RD STE 29
LAUREL MD
20707-3596
US

V. Phone/Fax

Practice location:
  • Phone: 443-927-6186
  • Fax:
Mailing address:
  • Phone: 443-927-6186
  • 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: KENNETH UWAJEH
Title or Position: CEO
Credential:
Phone: 443-927-6186