Provider Demographics
NPI:1497099584
Name:PSI FAMILY SERVICES INC
Entity Type:Organization
Organization Name:PSI FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HORACE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-547-3870
Mailing Address - Street 1:7101 WISCONSIN AVE STE 7101
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4871
Mailing Address - Country:US
Mailing Address - Phone:301-654-3903
Mailing Address - Fax:301-654-4418
Practice Address - Street 1:701 M STREET SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NA
Practice Address - Zip Code:20003
Practice Address - Country:UM
Practice Address - Phone:202-547-3870
Practice Address - Fax:202-546-9642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD25574320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness