Tidemark Behavioral Health
Counselor, Mental Health in West Chester, PA. Organization (NPI-2).
NPI number1164051025
StatusActive
Last updated in NPPESApr 3, 2020
Details
- NPI
- 1164051025
- Entity type
- Organization (NPI-2)
- Legal business name
- Tidemark Behavioral Health
- Organization subpart
- No
- Enumeration date
- Apr 3, 2020
- Certification date
- Apr 3, 2020
- Last updated
- Apr 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
1272 Delmar AveWest Chester, PA 19380-4027
Phone 484-432-7882
Mailing address
13 Ryan Frost WayEssex, MD 21221-1646
Phone 484-432-7882
Authorized official
Ryne Laxton
Ceo
4844327882
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