| Pittman Behavioral Health Llc | |
|
102 Sleepy Hollow Dr Suite 204 Bunker Hill Building Middletown DE 19709-5841 | |
| (302) 365-0384 | |
| Not Available |
| Full Name | Pittman Behavioral Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 102 Sleepy Hollow Dr, Middletown, Delaware |
| Authorized Official Name and Position | Taresa Pittman (OWNER/NURSE PRACTITIONER) |
| Authorized Official Contact | 3023650384 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pittman Behavioral Health Llc 8 Bordeaux Blvd Newark DE 19702-4546 Ph: (302) 521-9954 | Pittman Behavioral Health Llc 102 Sleepy Hollow Dr Suite 204 Bunker Hill Building Middletown DE 19709-5841 Ph: (302) 365-0384 |
| NPI Number | 1053732883 |
|---|---|
| Provider Enumeration Date | 12/20/2013 |
| Last Update Date | 12/20/2013 |
| Medicare PECOS PAC ID | 7719117126 |
|---|---|
| Medicare Enrollment ID | O20140305000321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053732883 | NPI | - | NPPES |
| 1417380312 | Other | DE | NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | L8-0000124 (Delaware) | Primary |
| Provider Name | Taresa Pittman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417380312 PECOS PAC ID: 8628208030 Enrollment ID: I20140305000433 |
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