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General NPI Number Information
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NPI Number | 1851907158
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Entity Type | Organization
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Legal Business Name | BROAD MOUNTAIN HOLISTIC MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 225 WILMINGTON W CHESTER PIKE
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City | CHADDS FORD
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State | PA
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Zip | 19317-9011
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Country | US
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Telephone | 725-230-8541
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Fax |
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Provider Business Mailing Address
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Address Line | 663 WALLACE WAY
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City | WEATHERLY
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State | PA
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Zip | 18255-3359
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Country | US
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Telephone | 570-573-7549
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ARIANNA DEMPSEY
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Credential | PMHNP
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Telephone | 570-573-7549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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