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General NPI Number Information
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NPI Number | 1164169991
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Entity Type | Organization
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Legal Business Name | SALVATION MULTIPURPOSE COMMUNUTY OUTREACH
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Dates
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Enumeration Date | 05/13/2022
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 2319 MARYLAND AVE FL 1
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City | BALTIMORE
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State | MD
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Zip | 21218-5010
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Country | US
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Telephone | 443-438-7610
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Fax | 443-438-7809
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Provider Business Mailing Address
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Address Line | 2319 MARYLAND AVE FL 1
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City | BALTIMORE
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State | MD
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Zip | 21218-5010
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Country | US
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Telephone | 443-438-7610
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Fax | 443-438-7809
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Authorized Official
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Title or Position | PRESIDENT
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Name | AYODEJI DAVID OLORUNSOLA
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Credential |
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Telephone | 443-438-7610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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