Organization
SAMORA MTL HEALTH SERVICES INC
Active
Other names
n/a
Organization subpart
No
Provider details
NPI number
Authorized official
ADELEKE YUSUF (MANAGER)
(301) 633-1676
Entity
Organization
Contact information
Practice address
110 E PATAPSCO AVE, BALTIMORE, MD 21225-2693
(301) 633-1676
Mailing address
14204 WILD WOOD CT, UPPER MARLBORO, MD 20774-8580
(301) 633-1676
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3016331676
—
MD
Enumeration date
06/30/2022
Last updated
06/30/2022
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