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General NPI Number Information
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NPI Number | 1285309815
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Entity Type | Organization
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Legal Business Name | YOUTH & FAMILY BEHAVIORAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 2011 S 25TH ST STE 108
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City | FORT PIERCE
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State | FL
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Zip | 34947-4795
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Country | US
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Telephone | 772-242-1079
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Fax | 772-242-1296
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Provider Business Mailing Address
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Address Line | 2011 S 25TH ST STE 108
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City | FORT PIERCE
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State | FL
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Zip | 34947-4795
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Country | US
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Telephone | 772-242-1079
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Fax | 772-242-1296
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARIE MARCELLE A MONVAL
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Credential |
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Telephone | 772-242-1079
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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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