Provider Demographics
NPI:1073223442
Name:BEHAVIORAL HEALTH INTEGRATIVE CARE OF FL, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH INTEGRATIVE CARE OF FL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KOROGODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-444-3512
Mailing Address - Street 1:4020 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3918
Mailing Address - Country:US
Mailing Address - Phone:614-443-5125
Mailing Address - Fax:
Practice Address - Street 1:471 SPENCER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3675
Practice Address - Country:US
Practice Address - Phone:561-444-3512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty