Organization
MINDHAVEN HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELIX OSEGBOUN (MANAGING DIRECTOR)
(361) 389-2387
Entity
Organization
Contact information
Practice address
8130 HICKORY HOLLOW DR, GLEN BURNIE, MD 21060-8640
(361) 389-2387
Mailing address
8130 HICKORY HOLLOW DR, GLEN BURNIE, MD 21060-8640
(361) 389-2387
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
08/10/2024
Last updated
11/02/2024
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