Healthcare Provider Details
I. General information
NPI: 1851103840
Provider Name (Legal Business Name): TOTAL FAMILY BEHAVIORAL HEALTHCARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2025
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7800 W OAKLAND PARK BLVD STE 214
SUNRISE FL
33351-1126
US
IV. Provider business mailing address
PO BOX 16472
PLANTATION FL
33318-6472
US
V. Phone/Fax
- Phone: 954-431-7676
- Fax: 888-538-2226
- Phone: 305-778-3157
- Fax: 888-538-2226
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
MARJORIE
MAY
GILLESPIE
Title or Position: PRESIDENT
Credential: PHD
Phone: 305-778-3157