Provider Demographics
NPI:1417673062
Name:JOEPAL TRAINING AND HEALTH SERVICES
Entity Type:Organization
Organization Name:JOEPAL TRAINING AND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP/PMH
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSKEI
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP/PMH
Authorized Official - Phone:443-813-4272
Mailing Address - Street 1:9410 FULLERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3016
Mailing Address - Country:US
Mailing Address - Phone:443-813-4272
Mailing Address - Fax:
Practice Address - Street 1:9410 FULLERDALE AVE
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-3016
Practice Address - Country:US
Practice Address - Phone:443-813-4272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOEPAL TRAINING AND HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)