Provider Demographics
NPI:1174168033
Name:RIGHTPLACE FAMILY CLINIC
Entity type:Organization
Organization Name:RIGHTPLACE FAMILY CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLANIRETI
Authorized Official - Middle Name:O
Authorized Official - Last Name:ONABANJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-732-1009
Mailing Address - Street 1:10296 BALTIMORE NATIONAL PIKE STE A
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3670
Mailing Address - Country:US
Mailing Address - Phone:240-732-1009
Mailing Address - Fax:410-720-2745
Practice Address - Street 1:10296 BALTIMORE NATIONAL PIKE STE A
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3670
Practice Address - Country:US
Practice Address - Phone:240-732-1009
Practice Address - Fax:410-720-2745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD907673500Medicaid