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1164051025
TIDEMARK BEHAVIORAL HEALTH
WEST CHESTER, PA
NPI
1164051025
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Entity Type
Organization
Authorized Contact
RYNE LAXTON
CEO
484-432-7882
Organization Subpart ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2020-04-03
Last Update Date
2020-04-03
Business Address
TIDEMARK BEHAVIORAL HEALTH
1272 DELMAR AVE
WEST CHESTER, PA 19380-4027
Phone number: 484-432-7882
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Mailing Address
TIDEMARK BEHAVIORAL HEALTH
13 RYAN FROST WAY
ESSEX, MD 21221-1646
Phone number: 484-432-7882
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