Provider Demographics
NPI:1194200931
Name:ALLOVER HEALTHCARE GROUP LLC
Entity Type:Organization
Organization Name:ALLOVER HEALTHCARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMIOSHO
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOJIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-759-8827
Mailing Address - Street 1:5450 REISTERSTOWN RD STE 304
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4436
Mailing Address - Country:US
Mailing Address - Phone:443-759-8827
Mailing Address - Fax:443-759-8870
Practice Address - Street 1:5450 REISTERSTOWN RD STE 304
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4436
Practice Address - Country:US
Practice Address - Phone:443-759-8827
Practice Address - Fax:443-759-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5001871Medicaid