Provider Demographics
NPI:1104273952
Name:SETIF INC
Entity type:Organization
Organization Name:SETIF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADEMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWAROTIMI
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:IKUSIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-446-3070
Mailing Address - Street 1:908 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2905
Mailing Address - Country:US
Mailing Address - Phone:301-446-3070
Mailing Address - Fax:301-446-3071
Practice Address - Street 1:4920 NIAGARA RD STE 107
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1121
Practice Address - Country:US
Practice Address - Phone:301-446-3070
Practice Address - Fax:301-446-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No305R00000XManaged Care OrganizationsPreferred Provider Organization