Organization
LUMINOX HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLAYEMI ADUROTA PMHNP (PRESIDENT)
(240) 825-9529
Entity
Organization
Contact information
Practice address
4001 PENDENNIS CT, UPPER MARLBORO, MD 20772-8304
(240) 553-7970
(347) 588-2943
Mailing address
4001 PENDENNIS CT, UPPER MARLBORO, MD 20772-8304
(240) 553-7970
(347) 588-2943
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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