Healthcare Provider Details

I. General information

NPI: 1588065676
Provider Name (Legal Business Name): FAMILY ENRICHMENT BEHAVIORAL HEALTH SYSTEMS II, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6067 HOLLYWOOD BLVD SUITE 335
HOLLYWOOD FL
33024-7947
US

IV. Provider business mailing address

6067 HOLLYWOOD BLVD SUITE 335
HOLLYWOOD FL
33024-7947
US

V. Phone/Fax

Practice location:
  • Phone: 954-367-3600
  • Fax: 954-367-3601
Mailing address:
  • Phone: 954-367-3600
  • Fax: 954-367-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1821240196
License Number StateFL

VIII. Authorized Official

Name: YVES JOSEPH
Title or Position: CEO
Credential: MS CABA
Phone: 954-367-3600