Healthcare Provider Details

I. General information

NPI: 1538520804
Provider Name (Legal Business Name): FOUNDING FATHERS ELDERLY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 ORCHARD ORIOLE WAY
ODENTON MD
21113-6038
US

IV. Provider business mailing address

2720 ORCHARD ORIOLE WAY
ODENTON MD
21113-6038
US

V. Phone/Fax

Practice location:
  • Phone: 301-326-5867
  • Fax: 301-627-3968
Mailing address:
  • Phone: 301-326-5867
  • Fax: 301-627-3968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1009677
License Number StateDC

VIII. Authorized Official

Name: TAIWO OLUYEMO
Title or Position: OWNER
Credential: NP
Phone: 202-785-2577