Provider Demographics
NPI:1194446450
Name:ENFIELD LOCKE CARE RESOURCES INC
Entity type:Organization
Organization Name:ENFIELD LOCKE CARE RESOURCES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TEMIDAYO
Authorized Official - Middle Name:A
Authorized Official - Last Name:OGUNDIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-558-6938
Mailing Address - Street 1:405 FREDERICK RD STE 158
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4633
Mailing Address - Country:US
Mailing Address - Phone:667-407-2550
Mailing Address - Fax:443-327-4613
Practice Address - Street 1:405 FREDERICK RD STE 158
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4633
Practice Address - Country:US
Practice Address - Phone:667-407-2550
Practice Address - Fax:443-327-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
No273Y00000XHospital UnitsRehabilitation Unit