| Tidemark Behavioral Health | |
|
1272 Delmar Ave West Chester PA 19380-4027 | |
| (484) 432-7882 | |
| Not Available |
| Full Name | Tidemark Behavioral Health |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1272 Delmar Ave, West Chester, Pennsylvania |
| Authorized Official Name and Position | Ryne Laxton (CEO) |
| Authorized Official Contact | 4844327882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidemark Behavioral Health 13 Ryan Frost Way Essex MD 21221-1646 Ph: (484) 432-7882 | Tidemark Behavioral Health 1272 Delmar Ave West Chester PA 19380-4027 Ph: (484) 432-7882 |
| NPI Number | 1164051025 |
|---|---|
| Provider Enumeration Date | 04/03/2020 |
| Last Update Date | 04/03/2020 |
| Certification Date | 04/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164051025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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