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General NPI Number Information
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NPI Number | 1457186892
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Entity Type | Organization
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Legal Business Name | GREEN MOUNTAIN BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 480 COLD SPRINGS RD
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City | GETTYSBURG
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State | PA
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Zip | 17325-7334
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Country | US
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Telephone | 571-620-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 440 EISENHOWER DR # 1036
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City | HANOVER
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State | PA
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Zip | 17331-5221
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Country | US
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Telephone | 717-389-1222
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TARYN WALKER
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Credential | PSYD
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Telephone | 717-389-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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