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General NPI Number Information
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NPI Number | 1972121218
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Entity Type | Organization
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Legal Business Name | CENTIA HEALTH LLC
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 8016 STATE LINE RD STE 205
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-3713
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Country | US
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Telephone | 610-400-4885
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Fax | 610-273-5542
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Provider Business Mailing Address
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Address Line | 150 S WARNER RD STE 130
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2826
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Country | US
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Telephone | 610-400-4885
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Fax | 610-273-5542
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Authorized Official
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Title or Position | FOUNDER, CHIEF MEDICAL OFFICER
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Name | DR. SOSUNMOLU OPEYEMI SHOYINKA
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Credential | MD
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Telephone | 917-589-4879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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