Provider Demographics
NPI:1598413155
Name:NEO HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:NEO HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EVARIST
Authorized Official - Middle Name:O
Authorized Official - Last Name:OGUGUO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP, DNP
Authorized Official - Phone:240-552-0264
Mailing Address - Street 1:110 PAINTERS MILL RD STE 108
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5545
Mailing Address - Country:US
Mailing Address - Phone:443-441-4080
Mailing Address - Fax:443-441-5081
Practice Address - Street 1:110 PAINTERS MILL RD STE 108
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5545
Practice Address - Country:US
Practice Address - Phone:443-441-5080
Practice Address - Fax:443-441-5081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)