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General NPI Number Information
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NPI Number | 1013449495
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Entity Type | Organization
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Legal Business Name | M B BEHAVIORAL HEALTH SERVICES-LLC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 4780 NW 24TH CT APT C215
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-2663
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Country | US
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Telephone | 954-601-6078
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26121
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City | FORT LAUDERDALE
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State | FL
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Zip | 33320-6121
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Country | US
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Telephone | 954-601-6078
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISS MARIE G BATEAU
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Credential |
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Telephone | 954-601-6078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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