Provider Demographics
NPI:1255949871
Name:ADEKOMI PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:ADEKOMI PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:RILWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ODEWALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-963-2660
Mailing Address - Street 1:611 FREDERICK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4779
Mailing Address - Country:US
Mailing Address - Phone:410-300-6461
Mailing Address - Fax:410-744-4253
Practice Address - Street 1:4515 HIDDEN STREAM CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4837
Practice Address - Country:US
Practice Address - Phone:410-300-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health