Provider Demographics
NPI:1477720241
Name:ROCK SOCIAL HEALTH INC
Entity type:Organization
Organization Name:ROCK SOCIAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADESOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OLALEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-496-2073
Mailing Address - Street 1:7818 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3863
Mailing Address - Country:US
Mailing Address - Phone:410-496-2073
Mailing Address - Fax:
Practice Address - Street 1:7818 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-3863
Practice Address - Country:US
Practice Address - Phone:410-496-2073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD407059300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health