Provider Demographics
NPI:1417094160
Name:PREMIER BEHAVIORAL SOLUTIONS OF FLORIDA, INC.
Entity Type:Organization
Organization Name:PREMIER BEHAVIORAL SOLUTIONS OF FLORIDA, INC.
Other - Org Name:SUNCOAST BEHAVIORAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SRVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:1324 37TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-4555
Mailing Address - Country:US
Mailing Address - Phone:941-792-2222
Mailing Address - Fax:941-761-1632
Practice Address - Street 1:1324 37TH AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-4555
Practice Address - Country:US
Practice Address - Phone:941-792-2222
Practice Address - Fax:941-761-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL320800000X
FL4356323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHS927PIMedicaid
DC034730600Medicaid
FL070565900Medicaid
086070OtherVALUE OPTIONS
FLE1GOtherBLUE CROSS BLUE SHIELD
NV100502475Medicaid
CA004835OtherBLUE CROSS BLUE SHIELD
FL070565916Medicaid
MD409164700Medicaid