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General NPI Number Information
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NPI Number | 1376499376
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Entity Type | Organization
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Legal Business Name | ROOTS OF HOPE LLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 10647 BREWERTON LN
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City | NEW MARKET
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State | MD
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Zip | 21774-6768
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Country | US
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Telephone | 512-788-8867
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 GUILFORD DR STE 200
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City | FREDERICK
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State | MD
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Zip | 21704-5264
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLY AMIKE NGENGE
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Credential |
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Telephone | 512-788-8867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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