Provider Demographics
NPI:1841976750
Name:BIOPSYCHIATRY THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:BIOPSYCHIATRY THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/ PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-938-0543
Mailing Address - Street 1:PO BOX 1773
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20717
Mailing Address - Country:US
Mailing Address - Phone:240-938-0543
Mailing Address - Fax:
Practice Address - Street 1:12301 KEMMERTON LANE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715
Practice Address - Country:US
Practice Address - Phone:240-938-0543
Practice Address - Fax:855-922-3172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health