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Organization
ELITE MULTI SPECIALTY CLINIC, LLC
Active
Organization
ELITE MULTI SPECIALTY CLINIC, LLC
Active
Other names
Elite Multi Specialty Clinic, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ADAORA PERPETUA NOUMMY (OFFICE ADMIN)
(301) 592-1780
Entity
Organization
Contact information
Practice address
12501 PROSPERITY DR STE 330, SILVER SPRING, MD 20904-1655
(301) 592-1780
(240) 645-4013
Mailing address
12501 PROSPERITY DR STE 330, SILVER SPRING, MD 20904-1655
(301) 592-1780
(240) 645-4013
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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