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TIDALHEALTH PENINSULA REGIONAL INC. NPI 1912473265


NPI Information

NPI: 1912473265
Provider Name: TIDALHEALTH PENINSULA REGIONAL, INC.

Doing Business As: TIDALHEALTH CRISIS

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

CLIA Number: 21D2255133

Address:
200 E. VINE STREET
TIDALHEALTH CRISIS CENTER
SALISBURY, MD
ZIP 21804
Phone: (410) 543-7181
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TIDALHEALTH PENINSULA REGIONAL, INC. is an adult mental health clinic center in Salisbury, MD. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. TIDALHEALTH PENINSULA REGIONAL, INC. NPI is 1912473265. The provider is registered as an organization entity type.
The provider Is Doing Business As Tidalhealth Crisis.

The provider's business location address is:

200 E. VINE STREET
TIDALHEALTH CRISIS CENTER
SALISBURY, MD
ZIP 21804-180
Phone: (410) 543-7181
Fax: (410) 912-4972

The provider's authorized official is Mickey Griffin .
The authorized official title is Senior Director and has the following contact phone number (410) 543-7437.

The CLIA number assigned to this NPI record is 21D2255133 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/15/2018 and was last updated on 1/11/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
2261QM0850XClinic/CenterAdult Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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