NPI 1629671128

Mercy Health Systems INC.

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Randallstown, MD

Practice location

Address: 3725 Trent Rd, Randallstown, MD 21133-2806
Phone: (443) 600-2289

Authorised official

Name: Boluwaji Ogunyamoju
Title: Owner/Executive Director
Phone: (443) 600-2289

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1629671128
Entity type: Organization
NPI issued: 17 Nov 2020
Record last updated: 17 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.