Healthcare Provider Details

I. General information

NPI: 1689580540
Provider Name (Legal Business Name): ELITE PSYCHIATRY & BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 OBETZ RD
COLUMBUS OH
43207-4098
US

IV. Provider business mailing address

701 N FEDERAL HWY STE 601
HALLANDALE BEACH FL
33009-2467
US

V. Phone/Fax

Practice location:
  • Phone: 614-491-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC JARQUIN
Title or Position: FINANCIAL CONTROLLER
Credential:
Phone: 954-651-8332