Provider Demographics
NPI:1730974429
Name:FORE COUNSELLING HEALTH CENTRE
Entity type:Organization
Organization Name:FORE COUNSELLING HEALTH CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIKA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:OKONKWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-624-7121
Mailing Address - Street 1:1010 PARK AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5637
Mailing Address - Country:US
Mailing Address - Phone:410-624-7121
Mailing Address - Fax:
Practice Address - Street 1:4114 BOARMAN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4920
Practice Address - Country:US
Practice Address - Phone:301-357-4053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility