TIDALHEALTH PENINSULA REGIONAL INC. NPI 1306507579

NPI Information

NPI: 1306507579
Provider Name: TIDALHEALTH PENINSULA REGIONAL, INC.
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

CLIA Number: 21D0649930

Address:
201 HALL HWY
CRISFIELD, MD
ZIP 21817
Phone: (410) 968-1200
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TIDALHEALTH PENINSULA REGIONAL, INC. is an adult mental health clinic center in Crisfield, 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 1306507579. The provider is registered as an organization entity type.

The provider's business location address is:

201 HALL HWY
CRISFIELD, MD
ZIP 21817-237
Phone: (410) 968-1200

The provider's authorized official is Bruce Ishmael Ritchie .
The authorized official title is Sr. Vice President/cfo and has the following contact phone number (410) 543-7298.

The CLIA number assigned to this NPI record is 21D0649930 - hospital with a certificate type of Certificate of Accreditation.

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

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
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
2	261QM0850X	Clinic/Center	Adult Mental Health			Yes

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: 4/28/2024

NPI Synchronization or Removal

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