Healthcare Provider Details

I. General information

NPI: 1275800583
Provider Name (Legal Business Name): DR. SAHADEO PSYCHIATRIC CASE MANAGMENT AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 45TH ST #2
WEST PALM BEACH FL
33407-2376
US

IV. Provider business mailing address

1115 45TH ST #2
WEST PALM BEACH FL
33407-2376
US

V. Phone/Fax

Practice location:
  • Phone: 561-572-7961
  • Fax:
Mailing address:
  • Phone: 561-572-7961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: GLORIA INES MONTOYA
Title or Position: ADMINISTRATOR
Credential: MS. HUMAN RELATIONS
Phone: 561-572-7961