Provider Demographics
NPI:1114699709
Name:PROFESSIONAL HEALTHCARE & BEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:PROFESSIONAL HEALTHCARE & BEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YETIEM
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-416-1522
Mailing Address - Street 1:8333 NW 53RD ST STE 450
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4837
Mailing Address - Country:US
Mailing Address - Phone:786-442-4379
Mailing Address - Fax:
Practice Address - Street 1:8333 NW 53RD ST STE 450
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-4837
Practice Address - Country:US
Practice Address - Phone:786-442-4379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty