Provider Demographics
NPI:1942818653
Name:FORTUNE HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:FORTUNE HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOLAJI
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:OLADIPUPO
Authorized Official - Suffix:
Authorized Official - Credentials:FCO
Authorized Official - Phone:443-985-2873
Mailing Address - Street 1:5903 QUEEN ANNE ST
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-3918
Mailing Address - Country:US
Mailing Address - Phone:443-985-2873
Mailing Address - Fax:
Practice Address - Street 1:5903 QUEEN ANNE ST
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-3918
Practice Address - Country:US
Practice Address - Phone:443-985-2873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services