Organization
VINE HEALTH CARE
Active
Other names
VINE HEALTH CARE, INC
Organization subpart
No
Provider details
NPI number
Authorized official
OLUWAFEMI MOYOADE IKUSIKA (C.E.O)
(443) 621-1931
Entity
Organization
Contact information
Practice address
7131 LIBERTY RD STE 200, BALTIMORE, MD 21207-4599
(443) 850-1967
Mailing address
7131 LIBERTY RD STE 200, BALTIMORE, MD 21207-4599
(410) 637-3005
(410) 510-1522
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH2147
MD
Other
Enumeration date
10/06/2016
Last updated
08/17/2020
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