| Maryland Health Alliance, Inc. | |
|
7525 Greenway Center Dr Ste 207 Greenbelt MD 20770 | |
| (240) 473-2159 | |
| (240) 965-6935 |
| Full Name | Maryland Health Alliance, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7525 Greenway Center Dr Ste 207, Greenbelt, Maryland |
| Authorized Official Name and Position | Corey Andrew Williams (CEO) |
| Authorized Official Contact | 2404732159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Health Alliance, Inc. 7525 Greenway Center Dr Ste 207 Greenbelt MD 20770-3525 Ph: (240) 473-2159 | Maryland Health Alliance, Inc. 7525 Greenway Center Dr Ste 207 Greenbelt MD 20770 Ph: (240) 473-2159 |
| NPI Number | 1285053538 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 01/23/2019 |
| Medicare PECOS PAC ID | 1052675618 |
|---|---|
| Medicare Enrollment ID | O20180507001960 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285053538 | NPI | - | NPPES |
| 421908200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Maryland) | Primary |
| Provider Name | Benjamin A Adewale |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790702132 PECOS PAC ID: 0345229571 Enrollment ID: I20040805001643 |
| Provider Name | Folake D Aloba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255753489 PECOS PAC ID: 9436382249 Enrollment ID: I20140625000784 |
| Provider Name | Rolanda J Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073855706 PECOS PAC ID: 5698039253 Enrollment ID: I20180723000555 |
| Provider Name | Brian C Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427536580 PECOS PAC ID: 6901236363 Enrollment ID: I20200427000572 |
| Provider Name | Ernest Keyaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518504307 PECOS PAC ID: 2961873898 Enrollment ID: I20230131003508 |
| Provider Name | Heather Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962763912 PECOS PAC ID: 3971959503 Enrollment ID: I20231102000353 |
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