Organization
EMINENT HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ADEBOWALE OGIDIOLU (EXECUTIVE DIRECTOR)
(443) 985-5493
Entity
Organization
Contact information
Practice address
10560 MAIN ST STE 98-8, FAIRFAX, VA 22030-7132
(443) 985-5493
(410) 501-5140
Mailing address
10560 MAIN ST STE 98-8, FAIRFAX, VA 22030-7132
(443) 985-5493
(410) 501-5140
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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