MEDICARE: MBH OUTPATIENT SERVICES LLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1528999497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MBH OUTPATIENT SERVICES LLC

Provider Business Mailing Address
First Line	:	6574 N STATE ROAD 7 # 154
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33073-3625
Country	:	US
Telephone Number	:	954-675-6898
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 LAKEVIEW AVENUE
Second Line	:	UNIT C
City	:	LANTANA
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	954-675-6898
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL BORKOWSKI
Credential	:
Telephone Number	:	954-675-6898

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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