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General NPI Number Information
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NPI Number | 1073223442
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH INTEGRATIVE CARE OF FL, LLC
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 471 SPENCER DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-3675
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Country | US
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Telephone | 561-444-3512
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Fax |
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Provider Business Mailing Address
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Address Line | 4020 LAKE WORTH RD
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City | PALM SPRINGS
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State | FL
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Zip | 33461-3918
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Country | US
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Telephone | 614-443-5125
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MR. SCOTT KOROGODSKY
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Credential |
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Telephone | 561-444-3512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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