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NPI Code Detail

MEDICARE: EL ROI BEHAVIORAL HEALTH AND HOLISTIC CARE

MEDICARE: EL ROI BEHAVIORAL HEALTH AND HOLISTIC CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1770332405
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL ROI BEHAVIORAL HEALTH AND HOLISTIC CARE
Provider Business Mailing Address
First Line : 7404 EXECUTIVE PL STE 400
Second Line :
City : LANHAM
State : MD
Zip : 20706-6228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7404 EXECUTIVE PL STE 400
Second Line :
City : LANHAM
State : MD
Zip : 20706-6228
Country : US
Telephone Number : 240-374-2574
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AUGUSTINA AGARUWA
Credential :
Telephone Number : 240-374-2574
Provider Enumeration Date : 05/15/2024
Last Update Date : 09/11/2024

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Directions to “EL ROI BEHAVIORAL HEALTH AND HOLISTIC CARE ” Practice Location

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