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Organization
PRIMEHEALTH BEHAVIORAL HEALTHCARE SERVICES LLC
Active
Organization
PRIMEHEALTH BEHAVIORAL HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSES E IKEJIOFOR DNP (OWNER OF THE ENTITY)
(443) 869-2550
Entity
Organization
Contact information
Practice address
1501 SULGRAVE AVE, STE 301, BALTIMORE, MD 21209-3651
(443) 869-2550
(443) 869-2750
Mailing address
3711 STONEYBROOK RD, RANDALLSTOWN, MD 21133-4134
(443) 869-2550
(443) 869-2750
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
05/29/2025
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