MR. EFETOBORE OMADEVUAE
NPI 1275397556
Assisted Living Facility - Assisted Living, Mental Illness in Gwynn Oak, MD

Q: What is Efetobore Omadevuae's NPI number?

The NPI number for Efetobore Omadevuae is 1275397556. It was assigned to this individual provider in the NPPES registry on February 7, 2024.

Q: What is Efetobore Omadevuae's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Active since February 07, 2024

9 PINEKNOT CT, GWYNN OAK, MD 21207(443) 739-1209 Get Directions Write a Review

NPPES record last updated: February 7, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Efetobore Omadevuae NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. EFETOBORE OMADEVUAE (NPI 1275397556) is an individual assisted living, mental illness provider in Gwynn Oak, Maryland and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1275397556

Entity TypeIndividualMale

Primary Taxonomy3104A0625X

Provider Legal NameMR. EFETOBORE OMADEVUAE

Location Address9 PINEKNOT CTGwynn Oak, MD 21207-5585

Mailing Address6628 Ridgeborne DrRosedale, MD 21237-3871 · (443) 739-1209

Phone(443) 739-1209

Sole ProprietorYes

Enumeration DateFebruary 7, 2024

NPPES CertifiedFebruary 7, 2024

✔ NPI 1275397556 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities

Taxonomy Code3104A0625X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.

9 PINEKNOT CT, Gwynn Oak, MD 21207

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Efetobore Omadevuae's NPI number?

The NPI number for Efetobore Omadevuae is 1275397556. It was assigned to this individual provider in the NPPES registry on February 7, 2024.

Where is Efetobore Omadevuae located?

Efetobore Omadevuae practices at 9 Pineknot Ct, Gwynn Oak, MD 21207. The listed phone number is (443) 739-1209.

What is Efetobore Omadevuae's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

When was this NPI record last updated?

The NPPES record for Efetobore Omadevuae was last updated on February 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.