Organization
IMMACULATE HEALTHCARE SYSTEMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STELLA CHINONYEREM NNABUGWU (CEO)
(254) 856-1210
Entity
Organization
Contact information
Practice address
3511 W FOREST PARK AVE, BALTIMORE, MD 21216-1428
(443) 929-9090
Mailing address
3511 W FOREST PARK AVE, BALTIMORE, MD 21216-1428
(254) 856-1210
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
04/21/2022
Last updated
11/11/2025
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