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Organization

ESOWOH HEALTHCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUGUSTINA FOFANAH MS, BSN, RN (CEO)
(202) 304-0633
Entity
Organization

Contact information

Practice address
2115 N CHARLES ST, BALTIMORE, MD 21218-5760
(443) 869-4829
(443) 449-5651
Mailing address
2115 N CHARLES ST, BALTIMORE, MD 21218-5760
(202) 304-0633
(443) 449-5651

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
03/12/2024
Last updated
06/12/2024
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