Provider Demographics
NPI:1720600059
Name:NEW SPRING BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:NEW SPRING BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUWASINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNTOMI
Authorized Official - Suffix:
Authorized Official - Credentials:PHMNP
Authorized Official - Phone:240-244-0731
Mailing Address - Street 1:8508 TOPAZ CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3342
Mailing Address - Country:US
Mailing Address - Phone:240-244-0731
Mailing Address - Fax:
Practice Address - Street 1:6 POST OFFICE RD STE 103
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2746
Practice Address - Country:US
Practice Address - Phone:240-210-8000
Practice Address - Fax:240-624-6256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)