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General NPI Number Information
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NPI Number | 1942701123
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Entity Type | Organization
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Legal Business Name | BEACHWAY BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 2901 BROADWAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-5131
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Country | US
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Telephone | 561-990-5340
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 QUANTUM BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8627
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | JUDITH VICTOR
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Credential |
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Telephone | 561-404-9829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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