Healthcare Provider Details

I. General information

NPI: 1699371831
Provider Name (Legal Business Name): THE ALABI GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 08/11/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5628 WOODYARD ROAD
UPPER MARLBORO MD
20772
US

IV. Provider business mailing address

12138 CENTRAL AVE STE 301
MITCHELLVILLE MD
20721-1910
US

V. Phone/Fax

Practice location:
  • Phone: 240-636-1663
  • Fax:
Mailing address:
  • Phone: 240-636-1663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AWAWU ARAMIDE OJIKUTU
Title or Position: CEO
Credential: CRNP
Phone: 630-863-8982