Fobidaks Place LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FOBIDAKS PLACE LLC

Practice address

6404 Rosemont Ave
Baltimore, MD 21206-1851

Phone

(410) 615-1221

NPI assigned

Aug 24, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Akintunde David Otuyelu

Title

Director

Phone

(410) 615-1221

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1013791433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 ROSEMONT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212061851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 ROSEMONT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212061851",
            "telephone_number": "410-615-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOBIDAKS PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "OTUYELU",
        "authorized_official_first_name": "AKINTUNDE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-615-1221"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.