Healthcare Provider Details

I. General information

NPI: 1730885286
Provider Name (Legal Business Name): ATAAM HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 MARTIN BLVD STE 208
MIDDLE RIVER MD
21220-4103
US

IV. Provider business mailing address

1515 MARTIN BLVD STE 208
MIDDLE RIVER MD
21220-4103
US

V. Phone/Fax

Practice location:
  • Phone: 410-374-7748
  • Fax: 443-559-6195
Mailing address:
  • Phone: 410-374-7748
  • Fax: 443-559-6195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MODUPE GIWA
Title or Position: ADMINISTRATOR, CEO
Credential:
Phone: 856-313-0646