# CHIVIC HEALTHCARE SERVICES LLC

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

## Provider details

- **NPI number:** 1730784398
- **Authorized official:** DR. NDIDIAMAKA EZINNE MBAKPUO (MANAGING DIRECTOR)
- **Authorized official phone:** (301) 712-4637

## Contact information

- **Practice address:** 9470 ANNAPOLIS RD STE 416, LANHAM, MD 20706-3000
- **Practice address phone:** (202) 735-1010
- **Mailing address:** 9470 ANNAPOLIS RD STE 416, LANHAM, MD 20706-3000
- **Mailing address phone:** (202) 735-1010
- **Mailing address fax:** (202) 567-6361

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/02/2020
- **Last updated:** 09/11/2025