Provider Demographics
NPI:1578252144
Name:SDORA WELLBEING LLC
Entity type:Organization
Organization Name:SDORA WELLBEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMILOLA
Authorized Official - Middle Name:LOVETH
Authorized Official - Last Name:AJONGBOLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:443-858-6418
Mailing Address - Street 1:1700 REISTERSTOWN RD STE 109
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2978
Mailing Address - Country:US
Mailing Address - Phone:877-772-5150
Mailing Address - Fax:667-400-5108
Practice Address - Street 1:1700 REISTERSTOWN RD STE 109
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2978
Practice Address - Country:US
Practice Address - Phone:877-772-5150
Practice Address - Fax:667-400-5108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health