Organization
CHIVIC HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NDIDIAMAKA EZINNE MBAKPUO (MANAGING DIRECTOR)
(301) 712-4637
Entity
Organization
Contact information
Practice address
9470 ANNAPOLIS RD STE 416, LANHAM, MD 20706-3000
(202) 735-1010
Mailing address
9470 ANNAPOLIS RD STE 416, LANHAM, MD 20706-3000
(202) 735-1010
(202) 567-6361
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
09/11/2025
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