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NPI Code Detail

MEDICARE: YOUTH & FAMILY BEHAVIORAL HEALTH CENTER, INC.

MEDICARE: YOUTH & FAMILY BEHAVIORAL HEALTH 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
1251B00000XCase Management Agency
2302R00000XHealth Maintenance Organization
3343900000XNon-emergency Medical Transport (VAN)
4251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619420130
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUTH & FAMILY BEHAVIORAL HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 2011 S 25TH ST STE 108
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-4795
Country : US
Telephone Number : 772-242-1079
Fax Number :
Provider Business Practice Location Address
First Line : 2011 S 25TH ST STE 108
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-4795
Country : US
Telephone Number : 772-242-1079
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. JEAN MARY MONVAL
Credential : MS
Telephone Number : 772-242-1079
Provider Enumeration Date : 08/02/2016
Last Update Date : 03/07/2024

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Directions to “YOUTH & FAMILY BEHAVIORAL HEALTH CENTER, INC. ” Practice Location

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