Organization
KINGDOM BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAOFEEK BELLO NURSE PRACTITIONER (PRESISENT/ CEO)
(240) 284-4641
Entity
Organization
Contact information
Practice address
5 PUBLIC SQ STE 213, HAGERSTOWN, MD 21740-5599
(240) 284-4641
(240) 284-4671
Mailing address
5 PUBLIC SQ STE 213, HAGERSTOWN, MD 21740-5599
(240) 284-4641
(240) 284-4671
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007559100
—
MD
Enumeration date
05/18/2020
Last updated
06/03/2020
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