Provider Demographics
NPI:1578955340
Name:FAMILY PSYCHIATRIC CARE SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY PSYCHIATRIC CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:610-209-6797
Mailing Address - Street 1:1412 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3674
Mailing Address - Country:US
Mailing Address - Phone:610-209-6797
Mailing Address - Fax:
Practice Address - Street 1:1412 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3674
Practice Address - Country:US
Practice Address - Phone:610-209-6797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005245B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty