| Lives Savers Behavioral Health Llc | |
|
767 18th St Ne Washington DC 20002-7228 | |
| (202) 239-0059 | |
| Not Available |
| Full Name | Lives Savers Behavioral Health Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 767 18th St Ne, Washington, District Of Columbia |
| 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 Llc 211 S Jefferson St Ste 201 Frederick MD 21701-7012 Ph: (703) 337-5052 | Lives Savers Behavioral Health Llc 767 18th St Ne Washington DC 20002-7228 Ph: (202) 239-0059 |
| NPI Number | 1861255242 |
|---|---|
| Provider Enumeration Date | 01/30/2024 |
| Last Update Date | 01/30/2024 |
| Medicare PECOS PAC ID | 9638530249 |
|---|---|
| Medicare Enrollment ID | O20240401000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861255242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Oluwakemi Olubunmi Osidele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649649468 PECOS PAC ID: 0941507867 Enrollment ID: I20161214000548 |
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