Provider Demographics
NPI:1912568098
Name:ABLE BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:ABLE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:O
Authorized Official - Last Name:AKINLOSOTU
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP PMH
Authorized Official - Phone:301-474-0149
Mailing Address - Street 1:6215 GREENBELT RD STE GL3B
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2366
Mailing Address - Country:US
Mailing Address - Phone:301-474-0149
Mailing Address - Fax:301-474-0263
Practice Address - Street 1:6215 GREENBELT RD STE GL3B
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2366
Practice Address - Country:US
Practice Address - Phone:301-474-0149
Practice Address - Fax:301-474-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty