Provider Demographics
NPI:1336345727
Name:ATOSK HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:ATOSK HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OLADEINDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-321-6826
Mailing Address - Street 1:1055 TAYLOR AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8317
Mailing Address - Country:US
Mailing Address - Phone:410-321-6826
Mailing Address - Fax:
Practice Address - Street 1:1055 TAYLOR AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-8317
Practice Address - Country:US
Practice Address - Phone:410-321-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNS1309006251J00000X
MDMH - 1584251S00000X
MDR2448R251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD068201200Medicaid
MD823702600Medicaid
MD411693300Medicaid