Provider Demographics
NPI:1861272478
Name:PROBITY HEALTHCARE SERVICES & CLINIC, LLC
Entity type:Organization
Organization Name:PROBITY HEALTHCARE SERVICES & CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF NURSING PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:CHIDINMA
Authorized Official - Middle Name:
Authorized Official - Last Name:EZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-254-6807
Mailing Address - Street 1:8609 SCHAPPELL WAY
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-4072
Mailing Address - Country:US
Mailing Address - Phone:301-254-6807
Mailing Address - Fax:
Practice Address - Street 1:8609 SCHAPPELL WAY
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-4072
Practice Address - Country:US
Practice Address - Phone:301-254-6807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)