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General NPI Number Information
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NPI Number | 1316199029
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Entity Type | Organization
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Legal Business Name | FLORIDA COMMUNITY BEHAVIORAL CARE INC
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 6610 EMBASSY BLVD SUITE A
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City | PORT RICHEY
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State | FL
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Zip | 34668-4897
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Country | US
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Telephone | 727-849-2255
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Fax | 727-849-2202
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Provider Business Mailing Address
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Address Line | 6610 EMBASSY BLVD SUITE A
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City | PORT RICHEY
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State | FL
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Zip | 34668-4897
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Country | US
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Telephone | 727-849-2255
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Fax | 727-849-2202
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. GENER BROJAN
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Credential |
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Telephone | 727-642-7803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 7933
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License Number State | FL
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