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Organization
PROCARE WELLNESS LLC
Active
Organization
PROCARE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IWALOLA OMOJOLA (PRESIDENT)
(443) 868-4165
Entity
Organization
Contact information
Practice address
11155 DOLFIELD BLVD STE 116, OWINGS MILLS, MD 21117-3289
(443) 868-4165
Mailing address
11155 DOLFIELD BLVD STE 116, OWINGS MILLS, MD 21117-3289
(443) 868-4165
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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