Provider Demographics
NPI:1831704121
Name:UNIQUE HEALTH CLINIC, LLC
Entity type:Organization
Organization Name:UNIQUE HEALTH CLINIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CRNP-PMH
Authorized Official - Prefix:
Authorized Official - First Name:NKEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH
Authorized Official - Phone:301-769-6558
Mailing Address - Street 1:13938 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5000
Mailing Address - Country:US
Mailing Address - Phone:301-769-6370
Mailing Address - Fax:
Practice Address - Street 1:13938 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5000
Practice Address - Country:US
Practice Address - Phone:301-769-6370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIQUE HEALTH CLINIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-13
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty