Provider Demographics
NPI:1326816182
Name:CLEAR MIND HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:CLEAR MIND HEALTH SERVICES LLC
Other - Org Name:PERRY POINT MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:NURE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ALOYS
Authorized Official - Middle Name:CHIAFIE
Authorized Official - Last Name:TENKIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-750-1979
Mailing Address - Street 1:906 MATHER DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-4941
Mailing Address - Country:US
Mailing Address - Phone:302-750-1979
Mailing Address - Fax:443-378-7582
Practice Address - Street 1:906 MATHER DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-4941
Practice Address - Country:US
Practice Address - Phone:302-750-1979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)