Provider Demographics
NPI:1922854298
Name:AWAKEN PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:AWAKEN PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REMLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:CNP, MSN, PMHNP-BC
Authorized Official - Phone:781-561-6604
Mailing Address - Street 1:132 CHIEF JUSTICE CUSHING HWY STE 70
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 NORFOLK RD
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-2226
Practice Address - Country:US
Practice Address - Phone:781-561-6604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty