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Organization

EMMANUEL HEALTH CARE CENTER L.L.LC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ADEBOLA TOYOSI ADERETI (CEO)
(240) 603-0890
Entity
Organization

Contact information

Practice address
9633 LIBERTY RD STE D, RANDALLSTOWN, MD 21133-2435
(240) 603-0890
(443) 272-6766
Mailing address
9633 LIBERTY RD STE D, RANDALLSTOWN, MD 21133-2435
(240) 603-0890
(443) 272-6766

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
164W00000X
Licensed Practical Nurse
261QP2300X
Primary Care Clinic/Center
363LF0000X
Family Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
04/28/2021
Last updated
04/28/2021
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