| Tidalhealth Behavioral Health | |
|
200 E Vine St Salisbury MD 21804-5531 | |
| (410) 543-7119 | |
| Not Available |
| Full Name | Tidalhealth Behavioral Health |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 200 E Vine St, Salisbury, Maryland |
| Authorized Official Name and Position | Stephanie Gary (CFO) |
| Authorized Official Contact | 4109126059 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidalhealth Behavioral Health Po Box 2498 Salisbury MD 21802-2498 Ph: (410) 912-4976 | Tidalhealth Behavioral Health 200 E Vine St Salisbury MD 21804-5531 Ph: (410) 543-7119 |
| NPI Number | 1962027094 |
|---|---|
| Provider Enumeration Date | 06/15/2020 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962027094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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