Organization
UPWARD BOUND PSYCHIATRY & PSYCHOTHERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INGRID S JOBE BS (ADMINISTRATOR)
(717) 545-1427
Entity
Organization
Contact information
Practice address
4800 LINGLESTOWN RD, STE 303, HARRISBURG, PA 17112
(717) 545-1427
(717) 545-1428
Mailing address
2321 FOREST LANE, HAMSBURG, PA 17112
(717) 541-0659
(717) 545-1428
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD048681L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1560885
HIGHMARK BLUE SHIELD
—
01
—
50023462
BLUE CROSS
—
Enumeration date
03/28/2006
Last updated
08/22/2020
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