Provider Demographics
NPI:1568178937
Name:NOVUM HEALTH SERVICES INCORPORATED
Entity Type:Organization
Organization Name:NOVUM HEALTH SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YESIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:443-805-6706
Mailing Address - Street 1:1404 CRAIN HWY S STE 112
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4056
Mailing Address - Country:US
Mailing Address - Phone:240-682-6288
Mailing Address - Fax:
Practice Address - Street 1:1404 CRAIN HWY S STE 112
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4056
Practice Address - Country:US
Practice Address - Phone:144-369-8825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder