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Organization
CHANCE FOR LIFE INC
Active
Organization
CHANCE FOR LIFE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUWAKEMI FAGBUYI MSN, APRN, PMHNP-BC (OWNER OF ENTITY)
(202) 487-9587
Entity
Organization
Contact information
Practice address
6490 LANDOVER RD STE F6, CHEVERLY, MD 20785-1443
(202) 487-9587
(240) 770-7529
Mailing address
4623 MORNING GLORY TRL, BOWIE, MD 20720-4264
(202) 487-9587
(240) 770-7529
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/12/2024
Last updated
06/25/2026
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