| Lily Behavioral Health Services Llc | |
|
7375 Executive Pl Ste 400 Lanham MD 20706-2278 | |
| (202) 599-6819 | |
| Not Available |
| Full Name | Lily Behavioral Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7375 Executive Pl Ste 400, Lanham, Maryland |
| Authorized Official Name and Position | Elizabeth Olumese (DR) |
| Authorized Official Contact | 2025996819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lily Behavioral Health Services Llc 7375 Executive Pl Ste 400 Lanham MD 20706-2278 Ph: (202) 599-6819 | Lily Behavioral Health Services Llc 7375 Executive Pl Ste 400 Lanham MD 20706-2278 Ph: (202) 599-6819 |
| NPI Number | 1407538168 |
|---|---|
| Provider Enumeration Date | 08/02/2023 |
| Last Update Date | 04/13/2024 |
| Certification Date | 04/13/2024 |
| Medicare PECOS PAC ID | 5799131322 |
|---|---|
| Medicare Enrollment ID | O20231102000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407538168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Ire Olumese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164758603 PECOS PAC ID: 2860871837 Enrollment ID: I20220622000572 |
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