Individual
TUNDE AKINSAWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4128 BROWN BARK CIR, RANDALLSTOWN, MD 21133-2054
(443) 657-0024
Mailing address
617 W PATRICK ST STE 2, FREDERICK, MD 21701-4027
(443) 657-0024
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92-2715526
000
—
Enumeration date
01/31/2023
Last updated
12/01/2023
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