Organization
PSI ACIST PROGRAM
Active
Organization
PSI ACIST PROGRAM
Active
Parent organization
PSYCHOTHERAPEUTIC SERVICES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PSYCHOTHERAPEUTIC SERVICES INC
Authorized official
MARCIA LYNN CLENDANIEL (BILLING MANAGER)
(410) 810-2465
Entity
Organization
Contact information
Practice address
983 FOREST ST, DOVER, DE 19904-3447
(302) 480-9590
(302) 480-9591
Mailing address
983 FOREST ST, DOVER, DE 19904-3447
(302) 480-9590
(302) 480-9591
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1990037507
DE
Other
Enumeration date
09/07/2016
Last updated
05/02/2017
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