| NPI | 1710618152 |
|---|---|
| Doing Business As | MEDHAVEN LLC |
| Entity Type | Organization |
| Authorized Contact | OLUWAKEMI F BALOGUN C RN P 240-515-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 208000000X Pediatrics |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2023-11-27 |