# TRINITY DETOX AND FAMILY CLINIC,INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRINITY DETOX AND FAMILY CLINIC ,INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1518654268
- **Legal business name:** TRINITY DETOX AND FAMILY CLINIC ,INC
- **Authorized official:** DR. IFEYINWA IBEANU DNP, CRNP (MEDICAL DIRECTOR)
- **Authorized official phone:** (443) 969-2310

## Contact information

- **Practice address:** 1232 RACE RD STE 302, ROSEDALE, MD 21237-2382
- **Practice address phone:** (443) 969-2310
- **Mailing address:** 1232 RACE RD STE 302, ROSEDALE, MD 21237-2382
- **Mailing address phone:** (443) 969-2310

## 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:** 04/21/2023
- **Last updated:** 04/21/2023