Provider Demographics
NPI:1952560989
Name:PENINSULA MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:PENINSULA MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:FINEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-860-2673
Mailing Address - Street 1:102 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4933
Mailing Address - Country:US
Mailing Address - Phone:410-860-2673
Mailing Address - Fax:410-860-0450
Practice Address - Street 1:102 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4933
Practice Address - Country:US
Practice Address - Phone:410-860-2673
Practice Address - Fax:410-860-0450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENINSULA ADDICTION SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty