Provider Demographics
NPI:1043677420
Name:PHOENIX BEHAVIOR SOLUTIONS, CORP
Entity Type:Organization
Organization Name:PHOENIX BEHAVIOR SOLUTIONS, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELBA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-380-6775
Mailing Address - Street 1:10222 NW 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2308
Mailing Address - Country:US
Mailing Address - Phone:786-380-6775
Mailing Address - Fax:
Practice Address - Street 1:10222 NW 80TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-2308
Practice Address - Country:US
Practice Address - Phone:786-380-6775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management