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General NPI Number Information
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NPI Number | 1265954226
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Entity Type | Organization
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Legal Business Name | COMMUNITY THERAPEUTIC CENTER,INC
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 8181 PROFESSIONAL PL STE 213
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City | HYATTSVILLE
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State | MD
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Zip | 20785-7232
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Country | US
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Telephone | 240-764-5133
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Fax | 240-764-7477
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Provider Business Mailing Address
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Address Line | 8181 PROFESSIONAL PL STE 213
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City | HYATTSVILLE
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State | MD
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Zip | 20785-7232
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Country | US
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Telephone | 240-764-5133
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Fax | 240-764-7477
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EMMANUEL OLUFEMI OWOOJE
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Credential | NURSE
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Telephone | 240-764-5133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | MD
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