Healthcare Provider Details

I. General information

NPI: 1235841552
Provider Name (Legal Business Name): BEHAVIORAL HEALTH INTEGRATIVE CARE OF FL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5795 SUNSET DR STE 504-B
SOUTH MIAMI FL
33143-5315
US

IV. Provider business mailing address

471 SPENCER DR STE B
WEST PALM BEACH FL
33409-3675
US

V. Phone/Fax

Practice location:
  • Phone: 855-859-8810
  • Fax: 561-473-9426
Mailing address:
  • Phone: 855-859-8810
  • Fax: 561-473-9426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALICIA M PIERCE
Title or Position: CORPORATE OPS MANAGER
Credential:
Phone: 561-473-9426