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1275397556
EFETOBORE OMADEVUAE
GWYNN OAK, MD
NPI
1275397556
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
3104A0625X Assisted Living Facility, Assisted Living, Mental Illness
Enumeration Date
2024-02-07
Last Update Date
2024-02-07
Business Address
Mr. EFETOBORE OMADEVUAE
9 PINEKNOT CT
GWYNN OAK, MD 21207-5585
Phone number: 443-739-1209
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Mailing Address
Mr. EFETOBORE OMADEVUAE
6628 RIDGEBORNE DR
ROSEDALE, MD 21237-3871
Phone number: 443-739-1209
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