Provider Demographics
NPI:1497376404
Name:IOT BEHAVIORAL HEALTH CENTER INC
Entity Type:Organization
Organization Name:IOT BEHAVIORAL HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IYAWAMIWA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHITTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-833-7100
Mailing Address - Street 1:11 CHARTLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136
Mailing Address - Country:US
Mailing Address - Phone:410-833-7100
Mailing Address - Fax:410-833-0100
Practice Address - Street 1:11 CHARTLEY DRIVE
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-2001
Practice Address - Country:US
Practice Address - Phone:410-833-7100
Practice Address - Fax:410-833-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health