Provider Demographics
NPI:1285008318
Name:GLOBAL MEDICAL AND BEHAVIORAL HEALTH CORPORATION
Entity Type:Organization
Organization Name:GLOBAL MEDICAL AND BEHAVIORAL HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-997-2397
Mailing Address - Street 1:1183 SUWANEE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5916
Mailing Address - Country:US
Mailing Address - Phone:813-997-2397
Mailing Address - Fax:
Practice Address - Street 1:1183 SUWANEE RD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-5916
Practice Address - Country:US
Practice Address - Phone:813-997-2397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001221676251E00000X, 251J00000X
FLRN9365072251E00000X, 251J00000X
FLMH8653251S00000X, 320900000X
VA0701006086251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities