Provider Demographics
NPI:1679317440
Name:AFOGRAS LLC
Entity type:Organization
Organization Name:AFOGRAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINJIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-346-3508
Mailing Address - Street 1:13709 HOTOMTOT DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7157
Mailing Address - Country:US
Mailing Address - Phone:301-346-3508
Mailing Address - Fax:
Practice Address - Street 1:13709 HOTOMTOT DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7157
Practice Address - Country:US
Practice Address - Phone:301-346-3508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty