Provider Demographics
NPI:1770181620
Name:CENTIA HEALTH LLC
Entity Type:Organization
Organization Name:CENTIA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOSUNMOLU
Authorized Official - Middle Name:OPEMEMI
Authorized Official - Last Name:SHOYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:236-842-4328
Mailing Address - Street 1:7 MILLWRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1363
Mailing Address - Country:US
Mailing Address - Phone:236-842-4328
Mailing Address - Fax:
Practice Address - Street 1:108 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8096
Practice Address - Country:US
Practice Address - Phone:236-842-4328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty