Healthcare Provider Details

I. General information

NPI: 1750965208
Provider Name (Legal Business Name): A BETTER WAY BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SW PORT ST LUCIE BLVD STE 101 UNIT 5
PORT ST LUCIE FL
34984-5001
US

IV. Provider business mailing address

201 SW PORT ST LUCIE BLVD STE 101 UNIT 5
PORT ST LUCIE FL
34984-5001
US

V. Phone/Fax

Practice location:
  • Phone: 772-404-5850
  • Fax:
Mailing address:
  • Phone: 772-404-5850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: CARLOS MARQUEZ
Title or Position: OWNER, CEO
Credential:
Phone: 786-234-4979