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General NPI Number Information
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NPI Number | 1003637463
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Entity Type | Organization
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Legal Business Name | JUNCO BEHAVIORAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 7350 VAN DUSEN RD STE 390
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City | LAUREL
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State | MD
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Zip | 20707-5231
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Country | US
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Telephone | 240-520-2965
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Fax |
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Provider Business Mailing Address
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Address Line | 12501 OLD CHAPEL RD
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City | GLENN DALE
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State | MD
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Zip | 20769-8966
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Country | US
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Telephone | 240-520-2965
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | JULIA OLERU
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Credential |
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Telephone | 240-520-2965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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