# SOVEREIGNTY HEALTH SERVICES LLC

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

## Provider details

- **NPI number:** 1629699293
- **Authorized official:** KEHINDE TIJANI (OTR/L)
- **Authorized official phone:** (410) 940-1983

## Contact information

- **Practice address:** 5310 OLD COURT RD, RANDALLSTOWN, MD 21133-5243
- **Practice address phone:** (410) 940-1983
- **Mailing address:** 152 SPECTATOR LN, OWINGS MILLS, MD 21117-4444
- **Mailing address phone:** (410) 940-1983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/05/2020
- **Last updated:** 05/29/2024