Provider Demographics
NPI:1902498462
Name:IJKL SERVICES INCORPORATED
Entity Type:Organization
Organization Name:IJKL SERVICES INCORPORATED
Other - Org Name:PAX HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:UGORJI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-985-0391
Mailing Address - Street 1:3 TOKAY CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3729
Mailing Address - Country:US
Mailing Address - Phone:443-985-0391
Mailing Address - Fax:
Practice Address - Street 1:8600 LASALLE RD
Practice Address - Street 2:STE 321
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2011
Practice Address - Country:US
Practice Address - Phone:443-985-0391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-06
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty