Provider Demographics
NPI:1780092429
Name:RODESON HEALTH SYSTEMS, LLC
Entity type:Organization
Organization Name:RODESON HEALTH SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLUWOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:AJIBORODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-567-9217
Mailing Address - Street 1:1208 MAGNESS CT
Mailing Address - Street 2:
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017-1627
Mailing Address - Country:US
Mailing Address - Phone:443-567-9217
Mailing Address - Fax:
Practice Address - Street 1:1208 MAGNESS CT
Practice Address - Street 2:
Practice Address - City:BELCAMP
Practice Address - State:MD
Practice Address - Zip Code:21017-1627
Practice Address - Country:US
Practice Address - Phone:443-567-9217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health