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General NPI Number Information
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NPI Number | 1497099584
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Entity Type | Organization
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Legal Business Name | PSI FAMILY SERVICES INC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 701 M STREET SE
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City | WASHINGTON
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State | NA
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Zip | 20003
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Country | UM
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Telephone | 202-547-3870
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Fax | 202-546-9642
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Provider Business Mailing Address
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Address Line | 7101 WISCONSIN AVE STE 7101
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City | BETHESDA
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State | MD
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Zip | 20814-4871
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Country | US
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Telephone | 301-654-3903
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Fax | 301-654-4418
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HORACE GREEN
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Credential | M.D.
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Telephone | 202-547-3870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MD25574
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License Number State | DC
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