Healthcare Provider Details

I. General information

NPI: 1801705827
Provider Name (Legal Business Name): FORTUNATE HOMECARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 CRAIN HWY STE 407
WALDORF MD
20601-2818
US

IV. Provider business mailing address

2670 CRAIN HWY STE 407
WALDORF MD
20601-2818
US

V. Phone/Fax

Practice location:
  • Phone: 301-795-9455
  • Fax: 301-755-0166
Mailing address:
  • Phone: 301-795-9455
  • Fax: 301-755-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABIOLA OLADIMEJI
Title or Position: PRESIDENT
Credential:
Phone: 301-795-9455