| Divine Health Psychiatric Services Llc | |
|
117 E Cherry Hill Rd Reisterstown MD 21136-3023 | |
| (443) 204-3919 | |
| (410) 521-3671 |
| Full Name | Divine Health Psychiatric Services Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 117 E Cherry Hill Rd, Reisterstown, Maryland |
| Authorized Official Name and Position | Emmanuel Gbala (PRESIDENT) |
| Authorized Official Contact | 4432043919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Health Psychiatric Services Llc 117 E Cherry Hill Rd Reisterstown MD 21136-3023 Ph: (443) 204-3919 | Divine Health Psychiatric Services Llc 117 E Cherry Hill Rd Reisterstown MD 21136-3023 Ph: (443) 204-3919 |
| NPI Number | 1447930706 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 07/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447930706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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