| Erosun Behavioral Health Services Inc, | |
|
10811 Red Run Blvd Ste 110 Owings Mills MD 21117-5150 | |
| (410) 296-4641 | |
| Not Available |
| Full Name | Erosun Behavioral Health Services Inc, |
|---|---|
| Speciality | Clinic/Center |
| Location | 10811 Red Run Blvd Ste 110, Owings Mills, Maryland |
| Authorized Official Name and Position | Segun Oladunni (CEO) |
| Authorized Official Contact | 4102964641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erosun Behavioral Health Services Inc, 10811 Red Run Blvd Ste 204 Owings Mills MD 21117-5151 Ph: (410) 296-4641 | Erosun Behavioral Health Services Inc, 10811 Red Run Blvd Ste 110 Owings Mills MD 21117-5150 Ph: (410) 296-4641 |
| NPI Number | 1902409725 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 04/28/2022 |
| Certification Date | 04/28/2022 |
| Medicare PECOS PAC ID | 3375932981 |
|---|---|
| Medicare Enrollment ID | O20211119000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902409725 | NPI | - | NPPES |
| Provider Name | Victoria Mojibola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841789146 PECOS PAC ID: 3678838919 Enrollment ID: I20180607001380 |
| Provider Name | Adetutu Bolaji Awodipe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386157857 PECOS PAC ID: 8628326089 Enrollment ID: I20180802000101 |
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