Organization
PSYCHOTHERAPEUTIC COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL COOPER C.P.A (CHIEF FINANCIAL OFFICER)
(410) 778-9114
Entity
Organization
Contact information
Practice address
630 W DIVISION ST, SUITE F, DOVER, DE 19904-2760
(302) 674-3366
(302) 674-3360
Mailing address
PO BOX 690, SUITE I, CHESTERTOWN, MD 21620-0690
(410) 778-9114
(410) 778-7988
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
103TP2701X
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000930161
—
DE
Enumeration date
07/11/2006
Last updated
08/22/2020
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