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General NPI Number Information
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NPI Number | 1942841838
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Entity Type | Organization
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Legal Business Name | TEMAH HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 5310 OLD COURT RD STE 303
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-6202
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Country | US
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Telephone | 410-521-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4320 BROOKSIDE OAKS
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5169
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Country | US
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Telephone | 443-803-1295
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | TEMITOPE S WILLIAMS
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Credential | CRNP, PMH, FNP-BC
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Telephone | 410-521-8000
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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 |
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