| Tidalhealth Behavioral Health Peninsula | |
|
100 E Carroll St Salisbury MD 21801-5422 | |
| (410) 543-7119 | |
| Not Available |
| Full Name | Tidalhealth Behavioral Health Peninsula |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 100 E Carroll St, Salisbury, Maryland |
| Authorized Official Name and Position | Stephanie Renee 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 Peninsula P.o. Box 825461 Philadelphia PA 19182 Ph: (410) 912-6989 | Tidalhealth Behavioral Health Peninsula 100 E Carroll St Salisbury MD 21801-5422 Ph: (410) 543-7119 |
| NPI Number | 1437810785 |
|---|---|
| Provider Enumeration Date | 01/07/2022 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437810785 | 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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