| Lives Savers Behavioral Health | |
|
211 S Jefferson St Ste 201 Frederick MD 21701-7012 | |
| (240) 575-9940 | |
| Not Available |
| Full Name | Lives Savers Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 211 S Jefferson St Ste 201, Frederick, Maryland |
| Authorized Official Name and Position | Oluwakemi Osidele (PRESIDENT) |
| Authorized Official Contact | 2404150064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lives Savers Behavioral Health 211 S Jefferson St Ste 201 Frederick MD 21701-7012 Ph: (240) 415-0064 | Lives Savers Behavioral Health 211 S Jefferson St Ste 201 Frederick MD 21701-7012 Ph: (240) 575-9940 |
| NPI Number | 1730881756 |
|---|---|
| Provider Enumeration Date | 03/21/2023 |
| Last Update Date | 12/23/2023 |
| Certification Date | 12/23/2023 |
| Medicare PECOS PAC ID | 9638530249 |
|---|---|
| Medicare Enrollment ID | O20230731000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730881756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Selina M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700220175 PECOS PAC ID: 5193968097 Enrollment ID: I20131127000696 |
| Provider Name | Perpetua Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083142442 PECOS PAC ID: 2466712310 Enrollment ID: I20180214001035 |
| Provider Name | Oluwakemi Olubunmi Osidele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649649468 PECOS PAC ID: 0941507867 Enrollment ID: I20181221000756 |
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