Provider Demographics
NPI:1316571037
Name:SOUTHCOAST PSYCHIATRIC SERVICES INC
Entity Type:Organization
Organization Name:SOUTHCOAST PSYCHIATRIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-241-6628
Mailing Address - Street 1:5301 N FEDERAL HWY STE 270
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4910
Mailing Address - Country:US
Mailing Address - Phone:561-241-6628
Mailing Address - Fax:561-241-8653
Practice Address - Street 1:5301 N FEDERAL HWY STE 270
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-4910
Practice Address - Country:US
Practice Address - Phone:561-241-6628
Practice Address - Fax:561-241-8653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty