Provider Demographics
NPI:1528784147
Name:AMENA HEALTH & REHABILITATION SERVICES
Entity type:Organization
Organization Name:AMENA HEALTH & REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOROGBE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-722-4838
Mailing Address - Street 1:917 RIDGECREST WAY
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6385
Mailing Address - Country:US
Mailing Address - Phone:443-722-4838
Mailing Address - Fax:
Practice Address - Street 1:917 RIDGECREST WAY
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6385
Practice Address - Country:US
Practice Address - Phone:443-722-4838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health