Provider Demographics
NPI:1730885286
Name:ATAAM HEALTH CARE
Entity type:Organization
Organization Name:ATAAM HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MODUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-313-0646
Mailing Address - Street 1:1515 MARTIN BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-4103
Mailing Address - Country:US
Mailing Address - Phone:410-374-7748
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:410-374-7748
Practice Address - Fax:443-559-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty