NPIMap

Organization Active NPI

Mem Scepter Home & Behavioral

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Leonardtown, MD
National Provider Identifier
1861179269
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MEM SCEPTER HOME & BEHAVIORAL
Practice address
25484 Point Lookout Rd Ste 301a
Leonardtown, MD 20650-3842
Phone
(240) 309-4111
Fax
(240) 309-4095
NPI assigned
Jun 28, 2023
Organization subpart
Yes
Parent organization
MEM SCEPTER HOME & BEHAVIORALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Modupe Olufunke Adenekan, CRNP-PMH-BC
Title
President
Phone
(240) 309-4111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

25484 Point Lookout Rd Ste 301a
Leonardtown, MD 20650-3842

Mailing address

PO Box 1116
Leonardtown, MD 20650-1116
Phone (240) 309-4111

National Provider Directory

National Provider Directory
Tax ID family
Mem Scepter Home Behavioral4 organizations share this tax ID, including this one
Part of
Mem Scepter Home Behavioral

Other organizations with this tax ID 3

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

Locations

25484 Point Lookout Rd
Ste 301A
Leonardtown, MD 20650
Phone (240) 309-4111

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1861179269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1116",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206501116",
            "telephone_number": "240-309-4111",
            "fax_number": "240-309-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25484 POINT LOOKOUT RD STE 301A",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503842",
            "telephone_number": "240-309-4111",
            "fax_number": "240-309-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEM SCEPTER HOME & BEHAVIORAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEM SCEPTER HOME & BEHAVIORAL",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "ADENEKAN",
        "authorized_official_first_name": "MODUPE",
        "authorized_official_middle_name": "OLUFUNKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-309-4111",
        "authorized_official_credential": "CRNP-PMH-BC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

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