Provider Demographics
NPI:1104168632
Name:BE LITE MEDICAL STAFFING AGENCY
Entity type:Organization
Organization Name:BE LITE MEDICAL STAFFING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:OHUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, MSW
Authorized Official - Phone:866-682-8069
Mailing Address - Street 1:3704 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748
Mailing Address - Country:US
Mailing Address - Phone:866-682-8069
Mailing Address - Fax:301-630-6916
Practice Address - Street 1:3704 26TH AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748
Practice Address - Country:US
Practice Address - Phone:866-682-8069
Practice Address - Fax:301-630-6916
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BE LITE MEDICAL STAFFING AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0461592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty