Provider Demographics
NPI:1902477631
Name:PSYCHACHE SOLUTIONS LLC
Entity Type:Organization
Organization Name:PSYCHACHE SOLUTIONS LLC
Other - Org Name:TIFFANY JONES GRIEF RECOVERY SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-213-5014
Mailing Address - Street 1:4450 MITCHELLVILLE RD # 1043
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4450 MITCHELLVILLE RD # 1043
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3112
Practice Address - Country:US
Practice Address - Phone:301-213-5014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-03
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health