Provider Demographics
NPI:1154142420
Name:FLOSAIAH BEHAVIORAL HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:FLOSAIAH BEHAVIORAL HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMOLARA
Authorized Official - Middle Name:IRETIOLUWA
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-300-3648
Mailing Address - Street 1:2422 E MONUMENT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-2556
Mailing Address - Country:US
Mailing Address - Phone:301-300-3648
Mailing Address - Fax:
Practice Address - Street 1:2422 E MONUMENT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2556
Practice Address - Country:US
Practice Address - Phone:301-300-3648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation