# IMMACULATE BEHAVIORAL HEALTHCARE SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174319495
- **Authorized official:** OLUWATOYIN R ADELAKUN (OWNER OF ENTITY)
- **Authorized official phone:** (301) 377-4325

## Contact information

- **Practice address:** 2255 CRAIN HWY STE 205, WALDORF, MD 20601-3190
- **Practice address phone:** (301) 377-4325
- **Mailing address:** 10612 CHERYL TURN, WALDORF, MD 20603-6914
- **Mailing address phone:** (301) 377-4325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2025
- **Last updated:** 09/03/2025