Organization
GRACELAND PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADETIMBO ADEDIRAN PMHNP (PSYCHIATRIC NURSE PRACTITIONER)
(240) 722-9763
Entity
Organization
Contact information
Practice address
10451 MILL RUN CIR, OWINGS MILLS, MD 21117-5577
(888) 517-4888
Mailing address
9435 PARAGON CT, OWINGS MILLS, MD 21117-1408
(240) 722-9763
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
04/07/2021
Last updated
06/16/2021
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