Provider Demographics
NPI:1972121218
Name:CENTIA HEALTH LLC
Entity type:Organization
Organization Name:CENTIA HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOSUNMOLU
Authorized Official - Middle Name:OPEYEMI
Authorized Official - Last Name:SHOYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-589-4879
Mailing Address - Street 1:150 S WARNER RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2826
Mailing Address - Country:US
Mailing Address - Phone:610-400-4885
Mailing Address - Fax:610-273-5542
Practice Address - Street 1:8016 STATE LINE RD STE 205
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3713
Practice Address - Country:US
Practice Address - Phone:610-400-4885
Practice Address - Fax:610-273-5542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
550OtherNONE