Healthcare Provider Details

I. General information

NPI: 1871183228
Provider Name (Legal Business Name): ZURI THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 MAIN ST STE 3
LAUREL MD
20707-7101
US

IV. Provider business mailing address

413 MAIN ST STE 3
LAUREL MD
20707-7101
US

V. Phone/Fax

Practice location:
  • Phone: 667-256-5535
  • Fax:
Mailing address:
  • Phone: 667-256-5535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: OLUWASEYI OLADUNJOYE-PHILLIPS
Title or Position: PRESIDENT
Credential: PMHNP
Phone: 301-237-4151