Organization
AVENEL HOLISTIC HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NWAMAKA STEPHANIE OBIESIE (CEO)
(240) 451-8300
Entity
Organization
Contact information
Practice address
1300 MERCANTILE LN STE 142, LARGO, MD 20774-5331
(240) 451-8300
(240) 451-8305
Mailing address
1300 MERCANTILE LN STE 142, LARGO, MD 20774-5331
(240) 451-8300
(240) 451-8305
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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