Gerizim Psychiatric Care Llc | |
729 Ellen Dr Bear DE 19701-5801 | |
(302) 981-2529 | |
Not Available |
Full Name | Gerizim Psychiatric Care Llc |
---|---|
Speciality | Clinic/Center |
Location | 729 Ellen Dr, Bear, Delaware |
Authorized Official Name and Position | Delphine Fombi-ndifor (OWNER) |
Authorized Official Contact | 3029812529 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Gerizim Psychiatric Care Llc 729 Ellen Dr Bear DE 19701-5801 Ph: (302) 981-2529 | Gerizim Psychiatric Care Llc 729 Ellen Dr Bear DE 19701-5801 Ph: (302) 981-2529 |
NPI Number | 1093412983 |
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Provider Enumeration Date | 02/10/2023 |
Last Update Date | 02/10/2023 |
Certification Date | 02/10/2023 |
Medicare PECOS PAC ID | 8426423054 |
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Medicare Enrollment ID | O20230412001073 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093412983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Delphine Fombi-ndifor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720798432 PECOS PAC ID: 0244605871 Enrollment ID: I20230412001322 |
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