Emmanuel Health Care Center L.L.LC.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EMMANUEL HEALTH CARE CENTER L.L.LC.

Practice address

9633 Liberty Rd Ste D
Randallstown, MD 21133-2435

Phone

(240) 603-0890

Fax

(443) 272-6766

NPI assigned

Apr 28, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Adebola Toyosi Adereti

Title

Ceo

Phone

(240) 603-0890

Specialties & licenses 5

Addresses

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1851974885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9633 LIBERTY RD STE D",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332435",
            "telephone_number": "240-603-0890",
            "fax_number": "443-272-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9633 LIBERTY RD STE D",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332435",
            "telephone_number": "240-603-0890",
            "fax_number": "443-272-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL HEALTH CARE CENTER L.L.LC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "ADERETI",
        "authorized_official_first_name": "ADEBOLA",
        "authorized_official_middle_name": "TOYOSI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-603-0890",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "laptops",
            "affiliation": "N",
            "endpointDescription": "Used for storing patient's vital records",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "to store patient's information",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "patient's information",
            "address_1": "9633 Liberty Rd Ste D",
            "city": "Randallstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211332435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Tablets",
            "affiliation": "N",
            "endpointDescription": "Used for storing patient's information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9633 Liberty Rd Ste D",
            "city": "Randallstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211332435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elevate Together LLC
• Raven Keturah Ellis, LCPC
• Embrace Experience Supportive Services
• Ihuoma Gloria Emenuga, MD/MPH
• Emergency Medicine Associates PA PC
• Kobina Enchill, MD
• Victoria Eneremadu
• Nelly Enone
• Arpad James Erdos, PA-C
• Ryleigh Marie Etzweiler, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.