Provider Demographics
NPI:1003200924
Name:SANKOFA LLC
Entity Type:Organization
Organization Name:SANKOFA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-758-3682
Mailing Address - Street 1:801 KEY HWY
Mailing Address - Street 2:UNIT 442
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-3976
Mailing Address - Country:US
Mailing Address - Phone:301-758-3682
Mailing Address - Fax:
Practice Address - Street 1:801 KEY HWY
Practice Address - Street 2:UNIT 442
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3976
Practice Address - Country:US
Practice Address - Phone:301-758-3682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-28
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17157251S00000X
MD0896253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency