Organization
GANIYU BALOGUN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GANIYU BALOGUN (MANAGER)
(301) 494-4372
Entity
Organization
Contact information
Practice address
9410 WASHINGTON BLVD, LANHAM, MD 20706-3016
(301) 494-4372
Mailing address
9410 WASHINGTON BLVD, LANHAM, MD 20706-3016
(301) 494-4372
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
05/27/2012
Last updated
05/29/2012
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