Provider Demographics
NPI:1063117919
Name:AMENA HEALTH & REHABILITATION SERVICES
Entity type:Organization
Organization Name:AMENA HEALTH & REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:OMOROGBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-722-4838
Mailing Address - Street 1:917 RIDGECREST WAY
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6385
Mailing Address - Country:US
Mailing Address - Phone:443-722-4838
Mailing Address - Fax:
Practice Address - Street 1:1049 HILLEN ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5236
Practice Address - Country:US
Practice Address - Phone:443-722-4838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty