Provider Demographics
NPI:1508589128
Name:ALLIANZE INC
Entity Type:Organization
Organization Name:ALLIANZE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOJIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-759-1137
Mailing Address - Street 1:9609 WICKSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-8977
Mailing Address - Country:US
Mailing Address - Phone:443-759-1137
Mailing Address - Fax:
Practice Address - Street 1:526 S CONKLING ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4201
Practice Address - Country:US
Practice Address - Phone:443-759-1137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD220712864OtherMARYLAND BHA