Organization
AVENEL HOLISTIC HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NWAMAKA STEPHANIE OBIESIE (CEO)
(240) 451-8300
Entity
Organization
Contact information
Practice address
1300 MERCANTILE LN STE 142, LARGO, MD 20774-5331
(240) 451-8300
Mailing address
1300 MERCANTILE LN STE 142, LARGO, MD 20774-5331
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209355300
—
MD
Enumeration date
03/01/2023
Last updated
03/01/2023
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