Provider Demographics
NPI:1114682093
Name:REDEEM HEALTHCARE AND MEDICAL SYSTEMS 11 INC
Entity Type:Organization
Organization Name:REDEEM HEALTHCARE AND MEDICAL SYSTEMS 11 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOJIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-629-2435
Mailing Address - Street 1:2127 W PRATT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2244
Mailing Address - Country:US
Mailing Address - Phone:410-878-0655
Mailing Address - Fax:
Practice Address - Street 1:2127 W PRATT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2244
Practice Address - Country:US
Practice Address - Phone:410-878-0655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility