Provider Demographics
NPI:1023470747
Name:ADVANCED PSYCHIATRIC SERVICES, P.C,
Entity type:Organization
Organization Name:ADVANCED PSYCHIATRIC SERVICES, P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:NONE
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:636-931-4206
Mailing Address - Street 1:10124 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050-5426
Mailing Address - Country:US
Mailing Address - Phone:636-481-8007
Mailing Address - Fax:
Practice Address - Street 1:10124 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-5426
Practice Address - Country:US
Practice Address - Phone:636-481-8007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00176251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health