| Awesome Experience Psychiatric Services Llc | |
|
5557 Baltimore Ave Ste 500 Hyattsville MD 20781-1922 | |
| (202) 921-4211 | |
| Not Available |
| Full Name | Awesome Experience Psychiatric Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5557 Baltimore Ave Ste 500, Hyattsville, Maryland |
| Authorized Official Name and Position | Siyami Takha (PROVIDER) |
| Authorized Official Contact | 2027054133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awesome Experience Psychiatric Services Llc 5557 Baltimore Ave Ste 500 Hyattsville MD 20781-1922 Ph: (202) 921-4211 | Awesome Experience Psychiatric Services Llc 5557 Baltimore Ave Ste 500 Hyattsville MD 20781-1922 Ph: (202) 921-4211 |
| NPI Number | 1457949018 |
|---|---|
| Provider Enumeration Date | 01/08/2021 |
| Last Update Date | 01/08/2021 |
| Medicare PECOS PAC ID | 0143635342 |
|---|---|
| Medicare Enrollment ID | O20210729003628 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457949018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Siyami Takha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760995021 PECOS PAC ID: 7911335658 Enrollment ID: I20200313000005 |
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