Provider Demographics
NPI: | 1386959757 |
---|---|
Name: | RELIANCE HEALTH SERVICES PC |
Entity type: | Organization |
Organization Name: | RELIANCE HEALTH SERVICES PC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO/ MEDICAL DIRECTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ADEFOLAJU |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | OKETOKUN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD, MPH |
Authorized Official - Phone: | 301-832-0100 |
Mailing Address - Street 1: | PO BOX 91280 |
Mailing Address - Street 2: | |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20090-1280 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-636-5136 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1629 K ST NW STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20006-1631 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-636-9000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-08-10 |
Last Update Date: | 2023-10-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
DC | 101Y00000X, 208D00000X, 261QA0600X, 261QM0801X, 261QU0200X | |
251B00000X, 251E00000X, 253Z00000X, 261Q00000X, 261QR0401X, 261QR0405X, 261QR0800X, 276400000X, 323P00000X, 324500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 251E00000X | Agencies | Home Health | ||
No | 253Z00000X | Agencies | In Home Supportive Care | Group - Multi-Specialty | |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care | Group - Multi-Specialty |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
No | 261QR0800X | Ambulatory Health Care Facilities | Clinic/Center | Recovery Care | |
No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | |
No | 276400000X | Hospital Units | Rehabilitation, Substance Use Disorder Unit | Group - Multi-Specialty | |
No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | Group - Multi-Specialty | |
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |