Provider Demographics
NPI:1194498642
Name:IMPERATIVE HEALTHCARE SERVICES
Entity type:Organization
Organization Name:IMPERATIVE HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRAOYA
Authorized Official - Middle Name:NABOTH
Authorized Official - Last Name:ERUANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-357-4794
Mailing Address - Street 1:4301 GARDEN CITY DR STE 302
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-6105
Mailing Address - Country:US
Mailing Address - Phone:301-357-4794
Mailing Address - Fax:
Practice Address - Street 1:4301 GARDEN CITY DR STE 302
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-6105
Practice Address - Country:US
Practice Address - Phone:301-357-4794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health