Provider Demographics
NPI:1316408131
Name:BEACHES BEHAVIORAL, INC.
Entity Type:Organization
Organization Name:BEACHES BEHAVIORAL, INC.
Other - Org Name:BEACHES BEHAVIORAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GALLIANO-PARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-853-5900
Mailing Address - Street 1:PO BOX 51507
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32240-1507
Mailing Address - Country:US
Mailing Address - Phone:904-853-5900
Mailing Address - Fax:904-853-5885
Practice Address - Street 1:4141 SOUTHPOINT DR E STE A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8061
Practice Address - Country:US
Practice Address - Phone:904-853-5900
Practice Address - Fax:904-853-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty