Healthcare Provider Details

I. General information

NPI: 1164835856
Provider Name (Legal Business Name): PBC & ASSOCIATES MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4699 N FEDERAL HWY 102F
POMPANO BEACH FL
33064-6510
US

IV. Provider business mailing address

4699 N FEDERAL HWY 102F
POMPANO BEACH FL
33064-6510
US

V. Phone/Fax

Practice location:
  • Phone: 954-210-6070
  • Fax: 888-900-2325
Mailing address:
  • Phone: 954-210-6070
  • Fax: 888-900-2325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. ALAN DURETZ
Title or Position: CONSULTANT
Credential:
Phone: 954-366-2700