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General NPI Number Information
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NPI Number | 1013265404
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Entity Type | Organization
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Legal Business Name | APOPKA BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 1655 E SEMORAN BLVD STE 14
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City | APOPKA
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State | FL
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Zip | 32703-5629
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Country | US
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Telephone | 407-880-0290
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Fax | 407-880-0291
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Provider Business Mailing Address
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Address Line | 1655 E SEMORAN BLVD STE 14
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City | APOPKA
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State | FL
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Zip | 32703-5629
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Country | US
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Telephone | 407-880-0290
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Fax | 407-880-0291
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BRADLEY C HAMILTON
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Credential | MBA
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Telephone | 407-880-0290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH 8768
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License Number State | FL
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