Most Relevant Information
Provider Data
| NPI Number: | 1003459777 |
| Provider Name: | WALTER OBI |
| Entity Type: | Individual |
| Taxonomy Code: | 320900000X |
| Specialty: | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/24/2019 |
| Last Updated: | 10/24/2019 |
Provider Practice Location
4201 BROOKSIDE OAKS
OWINGS MILLS
MD
211175168
Practice Location Phone/Fax
| Phone: | 4437221360 |
| Fax: |
Provider Mailing Location
4201 BROOKSIDE OAKS
OWINGS MILLS
MD
211175168
Provider Mailing Phone/Fax
| Phone: | 4437221360 |
| Fax: |