MEDICARE: BEHAVIORAL HEALTH FAMILY CENTER INC

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1548762529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL HEALTH FAMILY CENTER INC

Provider Business Mailing Address
First Line	:	6115 STIRLING RD STE 208
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-7240
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6115 STIRLING RD STE 208
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-7240
Country	:	US
Telephone Number	:	954-999-0464
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAITE RODRIGUEZ
Credential	:
Telephone Number	:	954-908-5838

Provider Enumeration Date	:	03/06/2018
Last Update Date	:	03/06/2018

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