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Organization
REVERED-HOLISTIC HEALTHCARE LLC
Active
Organization
REVERED-HOLISTIC HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADETUTU AWODIPE PMHNP (PRESIDENT)
(443) 621-2203
Entity
Organization
Contact information
Practice address
9861 BROKEN LAND PKWY STE 100, COLUMBIA, MD 21046-3031
(410) 399-4240
(443) 381-0216
Mailing address
4518 RUNNYMEADE RD, OWINGS MILLS, MD 21117-6156
(410) 399-4240
(443) 381-0216
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
05/04/2023
Last updated
09/11/2025
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