Provider Demographics
NPI:1811727233
Name:GLADELL HEALTHCARE SERVICES
Entity type:Organization
Organization Name:GLADELL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:AGIRIGA
Authorized Official - Last Name:ANOKAM
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,CRNP-PMHNP-BC,RN
Authorized Official - Phone:202-421-5994
Mailing Address - Street 1:2512 GALESHEAD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8012
Mailing Address - Country:US
Mailing Address - Phone:202-421-5994
Mailing Address - Fax:
Practice Address - Street 1:2512 GALESHEAD DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8012
Practice Address - Country:US
Practice Address - Phone:202-421-5994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty