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NPI Code Detail

MEDICARE: HENDERSON BEHAVIORAL HEALTH, INC.

MEDICARE: HENDERSON BEHAVIORAL HEALTH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1053262709
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENDERSON BEHAVIORAL HEALTH, INC.
Provider Business Mailing Address
First Line : 4740 N STATE ROAD 7 STE 201
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33319-5839
Country : US
Telephone Number : 954-486-4005
Fax Number :
Provider Business Practice Location Address
First Line : 2900 W PROSPECT RD
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-2519
Country : US
Telephone Number : 954-486-4005
Fax Number : 954-497-3857
Authorized Official
Title or Position : DIRECTOR OF BILLING
Name : CAROL LOMAN
Credential :
Telephone Number : 954-486-4005
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “HENDERSON BEHAVIORAL HEALTH, INC. ” Practice Location

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