Provider Demographics
NPI:1164255204
Name:HEPHZIBAH PSYCHIATRY AND MEDICAL CENTER LLC
Entity type:Organization
Organization Name:HEPHZIBAH PSYCHIATRY AND MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:ABIOSEH
Authorized Official - Middle Name:
Authorized Official - Last Name:PIEH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:731-444-0866
Mailing Address - Street 1:514 CORIANDER CT
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-6022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:514 CORIANDER CT
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-6022
Practice Address - Country:US
Practice Address - Phone:731-444-0866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty