NPIMap

Organization Active NPI

Avenel Holistic Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Largo, MD
National Provider Identifier
1780383448
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
AVENEL HOLISTIC HEALTH SERVICES LLC
Practice address
1300 Mercantile LN Ste 142
Largo, MD 20774-5331
Phone
(240) 451-8300
NPI assigned
Mar 1, 2023
Last updated
Mar 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Mrs. Nwamaka Stephanie Obiesie
Title
Ceo
Phone
(240) 451-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1300 Mercantile LN Ste 142
Largo, MD 20774-5331

Mailing address

1300 Mercantile LN Ste 142
Largo, MD 20774-5331

Other identifiers 1

IdentifierTypeStateIssuer
209355300MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Avenel Holistic Health Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1780383448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 142",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 142",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745331",
            "telephone_number": "240-451-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENEL HOLISTIC HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "OBIESIE",
        "authorized_official_first_name": "NWAMAKA",
        "authorized_official_middle_name": "STEPHANIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-451-8300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209355300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.