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General NPI Number Information
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NPI Number | 1417300773
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Entity Type | Organization
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Legal Business Name | FOCUS BEHAVIORAL HEALTH AT THE BEACH LP
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Dates
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Enumeration Date | 07/21/2016
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 33712 WESCOATS RD UNIT 4
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City | LEWES
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State | DE
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Zip | 19958-4934
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Country | US
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Telephone | 302-762-2283
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Fax |
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Provider Business Mailing Address
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Address Line | 33712 WESCOATS RD UNIT 4
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City | LEWES
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State | DE
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Zip | 19958-4934
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Country | US
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Telephone | 302-762-2283
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GUILFORD HURST
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Credential | GENERAL PTR
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Telephone | 302-438-8058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2016603795
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License Number State | DE
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