MEDICARE: DR. SAHADEO PSYCHIATRIC CASE MANAGMENT AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343800000X	Secured Medical Transport (VAN)
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1275800583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. SAHADEO PSYCHIATRIC CASE MANAGMENT AGENCY

Provider Business Mailing Address
First Line	:	1115 45TH ST
Second Line	:	#2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2376
Country	:	US
Telephone Number	:	561-572-7961
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 45TH ST
Second Line	:	#2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2376
Country	:	US
Telephone Number	:	561-572-7961
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	GLORIA INES MONTOYA
Credential	:	MS. HUMAN RELATIONS
Telephone Number	:	561-572-7961

Provider Enumeration Date	:	11/30/2011
Last Update Date	:	11/30/2011

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