Provider Demographics
NPI:1790893519
Name:OSEKRE INTERNATIONAL ENTERPRISE
Entity Type:Organization
Organization Name:OSEKRE INTERNATIONAL ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADJELEY
Authorized Official - Middle Name:AMENG
Authorized Official - Last Name:OSEKRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC LICSW
Authorized Official - Phone:203-309-5215
Mailing Address - Street 1:4008 12TH STREET NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017
Mailing Address - Country:US
Mailing Address - Phone:202-309-5215
Mailing Address - Fax:
Practice Address - Street 1:4008 12TH STREET NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017
Practice Address - Country:US
Practice Address - Phone:202-309-5215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09852104100000X
DCLC302971104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401188100Medicaid
P71732Medicare UPIN
MD401188100Medicaid