Organization
SUMMIT HOLISTIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NJIDEKA UDOCHI MD (OWNER)
(410) 245-2414
Entity
Organization
Contact information
Practice address
6310 STEVENS FOREST RD STE 200, COLUMBIA, MD 21046-1036
(410) 245-2414
(410) 740-9005
Mailing address
6310 STEVENS FOREST RD STE 200, COLUMBIA, MD 21046-1036
(410) 245-2414
(410) 740-9005
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685900300
—
MD
01
—
D0051897
STATE LICENSE
MD
Enumeration date
08/24/2021
Last updated
02/09/2024
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