Provider Demographics
NPI:1144941766
Name:ZENITH PSYCHIATRIC & MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:ZENITH PSYCHIATRIC & MENTAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MSN, CRNP-PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:OLUKEMI
Authorized Official - Middle Name:R
Authorized Official - Last Name:OMOGOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-346-2201
Mailing Address - Street 1:12804 GREENES PROMISE CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5613
Mailing Address - Country:US
Mailing Address - Phone:301-346-2201
Mailing Address - Fax:
Practice Address - Street 1:12804 GREENES PROMISE CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-5613
Practice Address - Country:US
Practice Address - Phone:301-346-2201
Practice Address - Fax:301-350-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty