Healthcare Provider Details

I. General information

NPI: 1992443089
Provider Name (Legal Business Name): UPSCALE HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PARK CENTER CT STE 210
OWINGS MILLS MD
21117-5604
US

IV. Provider business mailing address

6 PARK CENTER CT STE 210
OWINGS MILLS MD
21117-5604
US

V. Phone/Fax

Practice location:
  • Phone: 410-413-1628
  • Fax: 410-413-1644
Mailing address:
  • Phone: 410-413-1628
  • Fax: 410-413-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AUGUSTINA OLAJUMOKE OPEEWE-OJO
Title or Position: NURSE PRACTITIONER; CEO
Credential: DNP, AGNP, PMHNP-BC
Phone: 443-271-3013