Provider Demographics
NPI:1861831521
Name:PSYCARE INC.,
Entity Type:Organization
Organization Name:PSYCARE INC.,
Other - Org Name:PSYCARE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DARNALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-385-1000
Mailing Address - Street 1:15303 ST RTE 170
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9585
Mailing Address - Country:US
Mailing Address - Phone:330-385-1000
Mailing Address - Fax:330-385-3588
Practice Address - Street 1:15303 ST RTE 170
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9585
Practice Address - Country:US
Practice Address - Phone:330-385-1000
Practice Address - Fax:330-385-3588
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSYCARE INC.,
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-17
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty