Provider Demographics
NPI:1851853568
Name:IJOMAH AND ASSOCIATES INC
Entity Type:Organization
Organization Name:IJOMAH AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VERNESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-686-6319
Mailing Address - Street 1:1431 W PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9061
Mailing Address - Country:US
Mailing Address - Phone:301-821-1671
Mailing Address - Fax:
Practice Address - Street 1:1431 W PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9061
Practice Address - Country:US
Practice Address - Phone:301-821-1671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IJOMAH AND ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness