Organization Name: | BROADLEAF BEHAVIORAL HEALTH PC |
NPI Number: | 1689755530 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID P JONES (SOLE PROPRIETOR) |
Mailing Address: | 9 Old Sawmill Ln Arundel |
State: | ME US |
Postal Code: | 040468164 |
Phone Number: | 2079858998 |
Fax Number: | 2079851281 |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 04/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | ME1558 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |