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General NPI Number Information
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NPI Number | 1720600059
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Entity Type | Organization
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Legal Business Name | NEW SPRING BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 6 POST OFFICE RD STE 103
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City | WALDORF
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State | MD
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Zip | 20602-2746
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Country | US
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Telephone | 240-210-8000
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Fax | 240-624-6256
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Provider Business Mailing Address
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Address Line | 8508 TOPAZ CT
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City | CLINTON
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State | MD
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Zip | 20735-3342
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Country | US
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Telephone | 240-244-0731
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. OLUWASINA OGUNTOMI
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Credential | PHMNP
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Telephone | 240-244-0731
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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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Taxonomy #2
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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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