Provider Demographics
NPI:1033834163
Name:HEALTHY OPTION CLINIC
Entity Type:Organization
Organization Name:HEALTHY OPTION CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:OLUFUNMILAYO
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-538-1383
Mailing Address - Street 1:8713 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-4650
Mailing Address - Country:US
Mailing Address - Phone:443-636-6002
Mailing Address - Fax:443-636-6007
Practice Address - Street 1:8713 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-4650
Practice Address - Country:US
Practice Address - Phone:443-636-6002
Practice Address - Fax:443-636-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)