Provider Demographics
NPI:1649411471
Name:ZENITH HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ZENITH HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:AYETIGBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MS
Authorized Official - Phone:410-244-8377
Mailing Address - Street 1:800 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5318
Mailing Address - Country:US
Mailing Address - Phone:410-244-8377
Mailing Address - Fax:410-244-5588
Practice Address - Street 1:800 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5318
Practice Address - Country:US
Practice Address - Phone:410-244-8377
Practice Address - Fax:410-244-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD412715300Medicaid