Healthcare Provider Details

I. General information

NPI: 1811688096
Provider Name (Legal Business Name): MHP BEHAVIORAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6788 BITTERBUSH PL
BOYNTON BEACH FL
33472-2940
US

IV. Provider business mailing address

6788 BITTERBUSH PL
BOYNTON BEACH FL
33472-2940
US

V. Phone/Fax

Practice location:
  • Phone: 786-391-6772
  • Fax:
Mailing address:
  • Phone: 786-391-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MERCEDES HERNANDEZ PONS
Title or Position: PRESIDENT
Credential:
Phone: 786-391-6772