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General NPI Number Information
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NPI Number | 1942933379
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Entity Type | Organization
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Legal Business Name | CARITAS CHRISTI
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Dates
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Enumeration Date | 07/04/2022
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 5457 TWIN KNOLLS RD STE 300
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City | COLUMBIA
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State | MD
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Zip | 21045-3296
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Country | US
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Telephone | 443-910-5658
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 BRIGADIER BLVD
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City | ODENTON
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State | MD
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Zip | 21113-1038
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Country | US
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Telephone | 240-491-2882
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GAELLE NYASA
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Credential | CRNP-PMH
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Telephone | 240-491-2882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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