Boniface Lebog
Boniface Lebog is a Community/Behavioral Health Agency in Bowie, Maryland. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
2508 Brooke Grove RdBowie, MD 20721-1885
Phone: (202) 894-6811
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Case Manager/Care Coordinator (primary) | Taxonomy 171M00000X |
|---|---|
| Community/Behavioral Health Agency | Taxonomy 251S00000X |
Record details
| NPI number | 1356029003 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 11, 2023 |
| Last updated in NPPES | July 21, 2023 |
| Certification date | July 21, 2023 |
| Mailing address | 2508 Brooke Grove Rd, Bowie, MD 20721-1885 |
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