Provider Demographics
NPI:1245574979
Name:NATIONAL PIKE HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:NATIONAL PIKE HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:410-744-8100
Mailing Address - Street 1:23 SHIPPING PL
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-4318
Mailing Address - Country:US
Mailing Address - Phone:410-282-5401
Mailing Address - Fax:410-282-5403
Practice Address - Street 1:23 SHIPPING PL
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-4318
Practice Address - Country:US
Practice Address - Phone:410-282-5401
Practice Address - Fax:410-282-5403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MDMH-1197251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty