Provider Demographics
NPI:1194853929
Name:AWELE SOCIAL HEALTH CLINIC, INC
Entity Type:Organization
Organization Name:AWELE SOCIAL HEALTH CLINIC, INC
Other - Org Name:ASH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AJIBIKE
Authorized Official - Middle Name:O
Authorized Official - Last Name:SALAKO-AKANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-857-5297
Mailing Address - Street 1:7515 ANNAPOLIS RD
Mailing Address - Street 2:STE 406
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1740
Mailing Address - Country:US
Mailing Address - Phone:443-857-5297
Mailing Address - Fax:410-467-9588
Practice Address - Street 1:7515 ANNAPOLIS RD
Practice Address - Street 2:STE 406
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-1740
Practice Address - Country:US
Practice Address - Phone:443-857-5297
Practice Address - Fax:410-467-9588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health