Active NPI
Largo Wellness Center, LLC
- Adult Day Care Clinic/Center
- Largo, MD
National Provider Identifier
1861147035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- LARGO WELLNESS CENTER, LLC
- Practice address
- 1450 Mercantile LN Ste 237
Largo, MD 20774-5464 - Phone
- (301) 636-0977
- Fax
- (240) 770-6916
- NPI assigned
- Feb 16, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paula Nneka Okanume
- Title
- Manager
- Phone
- (240) 636-0977
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
1450 Mercantile LN Ste 237
Largo, MD 20774-5464
Mailing address
14111 Mary Bowie Pkwy
Upper Marlboro, MD 20774-8572
Phone (301) 636-0977
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644969600000",
"number": "1861147035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14111 MARY BOWIE PKWY",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207748572",
"telephone_number": "301-636-0977",
"fax_number": "240-770-6916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 MERCANTILE LN STE 237",
"city": "LARGO",
"state": "MD",
"postal_code": "207745464",
"telephone_number": "301-636-0977",
"fax_number": "240-770-6916"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LARGO WELLNESS CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-16",
"last_updated": "2022-02-16",
"certification_date": "2022-02-16",
"status": "A",
"authorized_official_last_name": "OKANUME",
"authorized_official_first_name": "PAULA",
"authorized_official_middle_name": "NNEKA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "240-636-0977"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.