Provider Demographics
NPI:1346813177
Name:YOUTH & FAMILY BEHAVIORAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:YOUTH & FAMILY BEHAVIORAL HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE MARCELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-242-1079
Mailing Address - Street 1:3740 20TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2418
Mailing Address - Country:US
Mailing Address - Phone:772-252-9136
Mailing Address - Fax:772-242-1296
Practice Address - Street 1:3740 20TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2418
Practice Address - Country:US
Practice Address - Phone:772-252-9136
Practice Address - Fax:772-242-1296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251S00000XOther251S00000X