# ROSE GODWIN SUPPORT SERVICES, INC

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

## Provider details

- **NPI number:** 1487260584
- **Authorized official:** AYO OKORO (NURSE PRACTITIONER)
- **Authorized official phone:** (301) 907-1700

## Contact information

- **Practice address:** 13671 BALTIMORE AVE, LAUREL, MD 20707-5096
- **Practice address phone:** (301) 907-1700
- **Practice address fax:** (877) 714-8747
- **Mailing address:** 11226 CHERRY HILL RD APT 302, BELTSVILLE, MD 20705-3831
- **Mailing address phone:** (301) 907-1700
- **Mailing address fax:** (877) 714-8747

## 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:** 09/23/2020
- **Last updated:** 02/26/2024