Healthcare Provider Details

I. General information

NPI: 1760176622
Provider Name (Legal Business Name): NATIONAL PIKE HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CORPORATE CENTER CT STE D
WESTMINSTER MD
21157-3060
US

IV. Provider business mailing address

5411 OLD FREDERICK RD STE 13
BALTIMORE MD
21229-2126
US

V. Phone/Fax

Practice location:
  • Phone: 410-375-1540
  • Fax:
Mailing address:
  • Phone: 410-744-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. MOPELOLA OWOYEMI
Title or Position: COO
Credential:
Phone: 410-375-1540