| Eshcol Behavioral Services Llc | |
|
6223 Sweet Gum Ln Hanover MD 21076-2127 | |
| (617) 461-3856 | |
| Not Available |
| Full Name | Eshcol Behavioral Services Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 6223 Sweet Gum Ln, Hanover, Maryland |
| Authorized Official Name and Position | Akhere Gwan (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 6174613856 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eshcol Behavioral Services Llc 6223 Sweet Gum Ln Hanover MD 21076-2127 Ph: () - | Eshcol Behavioral Services Llc 6223 Sweet Gum Ln Hanover MD 21076-2127 Ph: (617) 461-3856 |
| NPI Number | 1053073940 |
|---|---|
| Provider Enumeration Date | 10/08/2021 |
| Last Update Date | 11/03/2021 |
| Certification Date | 11/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053073940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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