Organization
PITOC-BEHAVIORAL HEALTH SYSTEMS, LLC
Active
Other names
PITOC-Behavioral Health Systems, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
OMORUYI EPHRAIM K OKUNDAYE MSW, LCSW-C, LCADC (PINCIPAL INVESTIGATOR-CEO)
(443) 682-5807
Entity
Organization
Contact information
Practice address
16 W 25TH ST, BALTIMORE, MD 21218-5002
(443) 682-5807
Mailing address
PO BOX 7921, ESSEX, MD 21221-0921
(443) 682-5807
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
17618
MD
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
LCA369
MD
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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