Provider Demographics
NPI:1912788431
Name:AUGUSTIN PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:AUGUSTIN PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOURDAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-339-3936
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-0008
Mailing Address - Country:US
Mailing Address - Phone:484-339-3936
Mailing Address - Fax:484-339-3949
Practice Address - Street 1:999 BERKSHIRE BLVD STE 280
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1254
Practice Address - Country:US
Practice Address - Phone:484-339-3936
Practice Address - Fax:484-339-3949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)