| Centra Healthcare System | |
|
9505 Reisterstown Rd Ste 2se Owings Mills MD 21117-4451 | |
| (443) 870-0218 | |
| Not Available |
| Full Name | Centra Healthcare System |
|---|---|
| Speciality | Early Intervention Provider Agency |
| Location | 9505 Reisterstown Rd Ste 2se, Owings Mills, Maryland |
| Authorized Official Name and Position | Elizabeth Afolake Ofoha (CEO) |
| Authorized Official Contact | 4438700218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centra Healthcare System 5 Englefield Sq Owings Mills MD 21117-4410 Ph: (443) 870-0218 | Centra Healthcare System 9505 Reisterstown Rd Ste 2se Owings Mills MD 21117-4451 Ph: (443) 870-0218 |
| NPI Number | 1538928734 |
|---|---|
| Provider Enumeration Date | 03/18/2024 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538928734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
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