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General NPI Number Information
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NPI Number | 1881541209
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Entity Type | Organization
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Legal Business Name | BLUE OAK HEALTH SERVICES LLC
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 1818 NEW YORK AVE NE STE 225
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City | WASHINGTON
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State | DC
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Zip | 20002-1851
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Country | US
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Telephone | 123-456-7890
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Fax |
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Provider Business Mailing Address
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Address Line | 11817 FROST DR
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City | BOWIE
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State | MD
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Zip | 20720-4428
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Country | US
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Telephone | 123-456-7891
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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. NELSON BALINGWE
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Credential |
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Telephone | 123-456-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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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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