Provider Demographics
NPI:1093298234
Name:BEHAVIORAL SERVICES NETWORK LLC
Entity Type:Organization
Organization Name:BEHAVIORAL SERVICES NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-907-7470
Mailing Address - Street 1:8200 NW 41ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6204
Mailing Address - Country:US
Mailing Address - Phone:305-907-7470
Mailing Address - Fax:
Practice Address - Street 1:8200 NW 41ST ST STE 200
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6204
Practice Address - Country:US
Practice Address - Phone:305-907-7470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL848773Medicaid