Provider Demographics
NPI:1275775181
Name:AMERICAN PSYCHOLOGICAL ALLIANCE LLC
Entity Type:Organization
Organization Name:AMERICAN PSYCHOLOGICAL ALLIANCE LLC
Other - Org Name:AMERICAN BEHAVIORAL CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROJO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-572-0066
Mailing Address - Street 1:225 NE 34TH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3800
Mailing Address - Country:US
Mailing Address - Phone:305-572-0066
Mailing Address - Fax:866-621-0340
Practice Address - Street 1:225 NE 34TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3800
Practice Address - Country:US
Practice Address - Phone:305-572-0066
Practice Address - Fax:866-621-0340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7406251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health