Organization
OMEGA BEHAVIORAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUFUNKE TAIWO CRNP (NURSE PRACTIONER)
(301) 520-6782
Entity
Organization
Contact information
Practice address
4500 FORBES BLVD STE 200, LANHAM, MD 20706-6316
(301) 520-6782
Mailing address
1202 NORTHERN LIGHTS DR, UPPER MARLBORO, MD 20774-6049
(301) 520-6782
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
11/19/2024
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