Organization
CREST MANOR HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLUWATOSIN ADETOLA ADEKOYA RPH, MBA (CHIEF EXECUTIVE OFFICER (CEO))
(443) 690-5792
Entity
Organization
Contact information
Practice address
14 CROOKED WILLOW CT, CATONSVILLE, MD 21228-2417
(410) 788-0046
(410) 788-0046
Mailing address
14 CROOKED WILLOW CT, CATONSVILLE, MD 21228-2417
(410) 788-0046
(410) 788-0046
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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