Provider Demographics
NPI:1578259727
Name:ADORE MENTAL HEALTH & ADDICTION CLINIC INC
Entity Type:Organization
Organization Name:ADORE MENTAL HEALTH & ADDICTION CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUFUNMILAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELOYE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:667-379-6975
Mailing Address - Street 1:4812 LIBERTY HEIGHTS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-8032
Mailing Address - Country:US
Mailing Address - Phone:443-847-0988
Mailing Address - Fax:
Practice Address - Street 1:4812 LIBERTY HEIGHTS AVE STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-8032
Practice Address - Country:US
Practice Address - Phone:667-379-6975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)