Provider Demographics
NPI:1376855155
Name:DIVERSIFIED BEHAVIORAL HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:DIVERSIFIED BEHAVIORAL HEALTH SERVICES INC.
Other - Org Name:DBHS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:TU JUAN
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NBCC
Authorized Official - Phone:352-219-2276
Mailing Address - Street 1:2404 MONTE CARLO TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-3527
Mailing Address - Country:US
Mailing Address - Phone:352-219-2276
Mailing Address - Fax:
Practice Address - Street 1:2404 MONTE CARLO TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3527
Practice Address - Country:US
Practice Address - Phone:352-219-2276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4900251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health