Provider Demographics
NPI:1629815030
Name:ADAPTIVE MENTAL HEALTH LLC
Entity type:Organization
Organization Name:ADAPTIVE MENTAL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KEMUNTO
Authorized Official - Last Name:ABUGAH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:302-747-0939
Mailing Address - Street 1:369 NEVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9948
Mailing Address - Country:US
Mailing Address - Phone:302-747-0939
Mailing Address - Fax:
Practice Address - Street 1:369 NEVERLAND DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9948
Practice Address - Country:US
Practice Address - Phone:302-747-0939
Practice Address - Fax:410-747-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty