Provider Demographics
NPI:1942578133
Name:PSI SERVICES III, INC.
Entity Type:Organization
Organization Name:PSI SERVICES III, INC.
Other - Org Name:PSI FAMILY SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADVANCEMENT OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-552-7120
Mailing Address - Street 1:8301 PROFESSIONAL PL STE 205
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2353
Mailing Address - Country:US
Mailing Address - Phone:301-552-7120
Mailing Address - Fax:301-654-4418
Practice Address - Street 1:5820 DIX ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-6965
Practice Address - Country:US
Practice Address - Phone:202-547-3870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty