Provider Demographics
NPI:1568959112
Name:IJOMAH AND ASSOCIATES INC
Entity Type:Organization
Organization Name:IJOMAH AND ASSOCIATES INC
Other - Org Name:SAFE JOURNEY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:IJOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-821-1671
Mailing Address - Street 1:4607 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2123
Mailing Address - Country:US
Mailing Address - Phone:301-821-1671
Mailing Address - Fax:
Practice Address - Street 1:4607 69TH AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-2123
Practice Address - Country:US
Practice Address - Phone:301-821-1671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty