Organization
FUBE ENTERPRISES, LLC
Active
Other names
Bonte Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NGUFOR FUBE DIVINE CRNP-PMH (PRESIDENT)
(443) 230-2285
Entity
Organization
Contact information
Practice address
8210 JEREMIAH LN, COLUMBIA, MD 21044-4165
(443) 230-2285
(301) 368-6675
Mailing address
8210 JEREMIAH LN, COLUMBIA, MD 21044-4165
(443) 230-2285
(301) 368-6675
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
07/26/2024
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