| Psychiatric Services, Llc | |
|
506 Lovely Ave Baltic SD 57003-0328 | |
| (605) 529-5240 | |
| (605) 610-1561 |
| Full Name | Psychiatric Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 506 Lovely Ave, Baltic, South Dakota |
| Authorized Official Name and Position | Brenda L Johnson (OWNER) |
| Authorized Official Contact | 6055295240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Services, Llc 506 Lovely Ave P.o. Box 328 Baltic SD 57003-0328 Ph: (605) 529-5240 | Psychiatric Services, Llc 506 Lovely Ave Baltic SD 57003-0328 Ph: (605) 529-5240 |
| NPI Number | 1174890164 |
|---|---|
| Provider Enumeration Date | 11/19/2011 |
| Last Update Date | 05/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174890164 | NPI | - | NPPES |
| 20110813516668 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | CP000650 (South Dakota) | Primary |
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