Provider Demographics
NPI:1104658954
Name:HOUSE OF PSALMS 23, INC.
Entity type:Organization
Organization Name:HOUSE OF PSALMS 23, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HASTE
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:680-283-7506
Mailing Address - Street 1:1539 E GENESEE ST # 3
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1100
Mailing Address - Country:US
Mailing Address - Phone:315-630-8613
Mailing Address - Fax:
Practice Address - Street 1:224 HARRISON ST STE 17
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3056
Practice Address - Country:US
Practice Address - Phone:680-283-7506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management