Organization
PSYCHOTHERAPEUTIC REHABILITATION SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL L COOPER CPA (CHIEF FINANCIAL OFFICER)
(410) 810-2468
Entity
Organization
Contact information
Practice address
337 BRIGHTSEAT RD STE 106&107, LANDOVER, MD 20785-4736
(301) 499-6870
(301) 499-1448
Mailing address
870 HIGH ST, SUITE 2, CHESTERTOWN, MD 21620-3914
(410) 778-1099
(410) 778-7988
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589181700
—
MD
Enumeration date
02/15/2007
Last updated
04/26/2023
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