Healthcare Provider Details

I. General information

NPI: 1689500381
Provider Name (Legal Business Name): WESTERN BEHAVIORAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 MANATEE AVE W STE L, OFFICE 118
BRADENTON FL
34209
US

IV. Provider business mailing address

6400 MANATEE AVE W STE L, OFFICE 118
BRADENTON FL
34209
US

V. Phone/Fax

Practice location:
  • Phone: 941-208-1878
  • Fax: 941-289-0879
Mailing address:
  • Phone: 941-208-1878
  • Fax: 941-289-0879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JORGE FELIX ALCINA
Title or Position: DIRECTOR
Credential: PSYD
Phone: 941-208-1878