Provider Demographics
NPI:1063832392
Name:KEY BEHAVIOR ESSENTIALS
Entity Type:Organization
Organization Name:KEY BEHAVIOR ESSENTIALS
Other - Org Name:GUIDED STEPS HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:QUINTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-557-9075
Mailing Address - Street 1:18425 NW 2ND AVE
Mailing Address - Street 2:310
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4534
Mailing Address - Country:US
Mailing Address - Phone:954-557-9075
Mailing Address - Fax:336-464-2227
Practice Address - Street 1:18425 NW 2ND AVE
Practice Address - Street 2:310
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4534
Practice Address - Country:US
Practice Address - Phone:954-557-9075
Practice Address - Fax:336-464-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009551900Medicaid