Provider Demographics
NPI:1497570519
Name:ATAAM HEALTH CARE
Entity type:Organization
Organization Name:ATAAM HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MODUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-374-7748
Mailing Address - Street 1:1009 WAMPLER RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1816
Mailing Address - Country:US
Mailing Address - Phone:856-313-0646
Mailing Address - Fax:443-559-6195
Practice Address - Street 1:1515 MARTIN BLVD STE 208
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-4103
Practice Address - Country:US
Practice Address - Phone:856-313-0646
Practice Address - Fax:443-559-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty