Provider Demographics
NPI:1497385876
Name:CBHS IPA, LLC
Entity Type:Organization
Organization Name:CBHS IPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:TUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:845-615-9312
Mailing Address - Street 1:70 HATFIELD LN STE 205
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6735
Mailing Address - Country:US
Mailing Address - Phone:845-615-9312
Mailing Address - Fax:
Practice Address - Street 1:70 HATFIELD LN STE 205
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6735
Practice Address - Country:US
Practice Address - Phone:845-615-9312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management