1518075589 NPI number — BEHAVIORAL HEALTH MANAGEMENT SVCS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518075589 NPI number — BEHAVIORAL HEALTH MANAGEMENT SVCS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHAVIORAL HEALTH MANAGEMENT SVCS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BAYCARE LIFE MANAGEMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518075589
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 403974
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-3974
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-852-3272
Provider Business Mailing Address Fax Number:
813-852-3233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 DR MARTIN LUTHER KING JR ST N
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33705-1472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-820-7747
Provider Business Practice Location Address Fax Number:
727-820-7795
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MASON
Authorized Official First Name:
STEVER
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
727-820-8002

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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