1912123456 NPI number — BAYVIEW CENTER FOR MENTAL HEALTH 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 1912123456 NPI number — BAYVIEW CENTER FOR MENTAL HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYVIEW CENTER FOR MENTAL HEALTH 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:
1912123456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 SE 3RD AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
FT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33316-1139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-414-8700
Provider Business Mailing Address Fax Number:
954-467-9966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
633 NE 167TH ST
Provider Second Line Business Practice Location Address:
SUITE 801
Provider Business Practice Location Address City Name:
NORTH MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33162-2442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-892-4600
Provider Business Practice Location Address Fax Number:
954-467-9966
Provider Enumeration Date:
04/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SLEEPER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO & PRES
Authorized Official Telephone Number:
954-414-8700

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 060279501 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060279513 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060279500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060279504 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060279503 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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