| Lives Savers Behavioral Health | |
|
102 N 21st St # 220 Purcellville VA 20132-5606 | |
| (240) 415-0064 | |
| (240) 415-0209 |
| Full Name | Lives Savers Behavioral Health |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 102 N 21st St # 220, Purcellville, Virginia |
| Authorized Official Name and Position | Oluwakemi Osidele (PRESIDENT) |
| Authorized Official Contact | 2405759940 |
| 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 102 N 21st St # 220 Purcellville VA 20132-5606 Ph: (240) 415-0064 |
| NPI Number | 1275395188 |
|---|---|
| Provider Enumeration Date | 01/25/2024 |
| Last Update Date | 01/30/2024 |
| Certification Date | 01/30/2024 |
| Medicare PECOS PAC ID | 9638530249 |
|---|---|
| Medicare Enrollment ID | O20240321001178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275395188 | NPI | - | NPPES |
| Provider Name | Oluwakemi Olubunmi Osidele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649649468 PECOS PAC ID: 0941507867 Enrollment ID: I20240321001981 |
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