Provider Demographics
NPI:1073274635
Name:FAVOR LLC
Entity Type:Organization
Organization Name:FAVOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TITILAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINSOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:301-793-8791
Mailing Address - Street 1:4B NORTH AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2304
Mailing Address - Country:US
Mailing Address - Phone:410-403-3299
Mailing Address - Fax:410-862-4350
Practice Address - Street 1:4B NORTH AVE STE 302
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2304
Practice Address - Country:US
Practice Address - Phone:410-403-3299
Practice Address - Fax:410-862-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care