Provider Demographics
NPI:1215636535
Name:TELEAURA PROVIDERS LLC
Entity type:Organization
Organization Name:TELEAURA PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MR
Authorized Official - First Name:MONSURU
Authorized Official - Middle Name:O
Authorized Official - Last Name:AKINYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-495-9635
Mailing Address - Street 1:8 THE GRN STE A
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3618
Mailing Address - Country:US
Mailing Address - Phone:833-252-2777
Mailing Address - Fax:
Practice Address - Street 1:8 THE GRN STE 4000
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3618
Practice Address - Country:US
Practice Address - Phone:339-207-0509
Practice Address - Fax:339-207-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health