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Organization

PSYCHOTHERAPEUTIC COMMUNITY SERVICES ASSOC

Active
Parent organization
525089072
Other names
PSI
Organization subpart
Yes

Provider details

NPI number
Legal business name
525089072
Authorized official
MARCIA LYNN CLENDANIEL (BILLING MANAGER)
(410) 810-2465
Entity
Organization

Contact information

Practice address
400 W MAIN ST STE 501, DURHAM, NC 27701-3295
(919) 530-8888
Mailing address
400 W MAIN ST STE 501, DURHAM, NC 27701-3295
(919) 530-8888

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
2662-A
NC

Other

Enumeration date
04/06/2015
Last updated
10/18/2016
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