Provider Demographics
NPI:1902490154
Name:DENOOR HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:DENOOR HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAFAYAT
Authorized Official - Middle Name:OLABISI
Authorized Official - Last Name:BELLO-OGUNDIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-232-9182
Mailing Address - Street 1:1935-1937 W PRATT ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2251
Mailing Address - Country:US
Mailing Address - Phone:571-232-9182
Mailing Address - Fax:
Practice Address - Street 1:1935 W PRATT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2251
Practice Address - Country:US
Practice Address - Phone:571-232-9182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty