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Organization
GILEAD ASSOCIATES LLC
Active
Organization
GILEAD ASSOCIATES LLC
Active
Other names
GILEAD Associates LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GBEMISOLA ELIZABETH MOJELOPE PMHNP-BC (CLINICAL DIRECTOR)
(667) 225-0673
Entity
Organization
Contact information
Practice address
7661 ARUNDEL MILLS BLVD, HANOVER, MD 21076-1305
(672) 250-6736
Mailing address
206 MULBERRY RIDGE CT, PASADENA, MD 21122-7514
(432) 038-0944
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W20623088
MARYLAND DEPARTMENT OF TAXATION-SDAT
MD
Enumeration date
09/28/2020
Last updated
09/08/2023
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