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General NPI Number Information
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NPI Number | 1467446724
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Entity Type | Organization
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Legal Business Name | THE JEROME GOLDEN CENTER FOR BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 1041 45TH ST
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2402
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Country | US
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Telephone | 561-383-5736
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Fax | 561-383-5922
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Provider Business Mailing Address
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Address Line | 1041 45TH ST
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2402
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Country | US
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Telephone | 561-383-5736
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Fax | 561-383-5922
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Authorized Official
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Title or Position | AR SPECIALIST
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Name | TRUMAN C PUGH
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Credential |
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Telephone | 210-789-0329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 3980
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License Number State | FL
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