Provider Demographics
NPI:1134785041
Name:UNIVERSALITY HEALTH CARE
Entity type:Organization
Organization Name:UNIVERSALITY HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:LABAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNNUPE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:202-276-9353
Mailing Address - Street 1:547 RIVERSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5369
Mailing Address - Country:US
Mailing Address - Phone:443-355-7517
Mailing Address - Fax:443-733-6050
Practice Address - Street 1:547 RIVERSIDE DR STE A
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5369
Practice Address - Country:US
Practice Address - Phone:443-355-7517
Practice Address - Fax:443-733-6050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty