Healthcare Provider Details
I. General information
NPI: 1750965745
Provider Name (Legal Business Name): HEALTHY MIND FOUNDATION AFRICA LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2021
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8101 SANDY SPRING RD SUITE 300, UNIT W29
LAUREL MD
20707-3596
US
IV. Provider business mailing address
8101 SANDY SPRING RD SUITE 300, UNIT W29
LAUREL MD
20707-3596
US
V. Phone/Fax
- Phone: 443-949-3798
- Fax: 667-803-7986
- Phone: 443-493-7985
- Fax: 667-803-7986
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KENNETH
UWAJEH
Title or Position: CEO
Credential: MD MPH
Phone: 443-927-6186