1851103840 NPI number — TOTAL FAMILY BEHAVIORAL HEALTHCARE CENTER, INC

Table of content: (NPI 1851103840)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851103840 NPI number — TOTAL FAMILY BEHAVIORAL HEALTHCARE CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL FAMILY BEHAVIORAL HEALTHCARE CENTER, 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:
Provider Other Organization Name Type Code:
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:
1851103840
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16472
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANTATION
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33318-6472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-778-3157
Provider Business Mailing Address Fax Number:
888-538-2226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7800 W OAKLAND PARK BLVD STE 214
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNRISE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33351-1126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-431-7676
Provider Business Practice Location Address Fax Number:
888-538-2226
Provider Enumeration Date:
01/25/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GILLESPIE
Authorized Official First Name:
MARJORIE
Authorized Official Middle Name:
MAY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-778-3157

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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