Provider Demographics
NPI:1114676871
Name:S & C PSYCHIATRIC SERVICES PA
Entity Type:Organization
Organization Name:S & C PSYCHIATRIC SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MR
Authorized Official - First Name:YVES
Authorized Official - Middle Name:GUALBERT
Authorized Official - Last Name:DEHAUT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:305-331-8695
Mailing Address - Street 1:PO BOX 849045
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33084-1045
Mailing Address - Country:US
Mailing Address - Phone:305-331-8695
Mailing Address - Fax:
Practice Address - Street 1:20760 NE 4TH CT APT 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1884
Practice Address - Country:US
Practice Address - Phone:305-331-8695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty