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Organization

ELITE MULTI SPECIALTY CLINIC, LLC

Active
Other names
Elite Multi Specialty Clinic, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
ADAORA PERPETUA NOUMMY (OFFICE ADMIN)
(301) 592-1780
Entity
Organization

Contact information

Practice address
12501 PROSPERITY DR STE 330, SILVER SPRING, MD 20904-1655
(301) 592-1780
(240) 645-4013
Mailing address
12501 PROSPERITY DR STE 330, SILVER SPRING, MD 20904-1655
(301) 592-1780
(240) 645-4013

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053758235
NPPES
DC
Enumeration date
08/12/2020
Last updated
08/12/2020
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