| Penuel Behavioral Health Services Llc | |
|
9708 Monroe St Ste 201 Cockeysville MD 21030-5081 | |
| (240) 565-7718 | |
| Not Available |
| Full Name | Penuel Behavioral Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9708 Monroe St Ste 201, Cockeysville, Maryland |
| Authorized Official Name and Position | Olabimpe Olojo (OWNER) |
| Authorized Official Contact | 2405657718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penuel Behavioral Health Services Llc 9708 Monroe St Ste 201 Cockeysville MD 21030-5081 Ph: (240) 565-7718 | Penuel Behavioral Health Services Llc 9708 Monroe St Ste 201 Cockeysville MD 21030-5081 Ph: (240) 565-7718 |
| NPI Number | 1275231383 |
|---|---|
| Provider Enumeration Date | 02/17/2023 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 0446786941 |
|---|---|
| Medicare Enrollment ID | O20241206002938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275231383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Olabimpe Olojo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073862959 PECOS PAC ID: 2365713583 Enrollment ID: I20170807002743 |
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