Provider Demographics
NPI:1417207192
Name:NATIONAL ALLIANCE ON MENTAL ILLNESS OF PALM BEACH
Entity Type:Organization
Organization Name:NATIONAL ALLIANCE ON MENTAL ILLNESS OF PALM BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-265-1099
Mailing Address - Street 1:1520 10TH AVE N
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-2069
Mailing Address - Country:US
Mailing Address - Phone:561-588-3477
Mailing Address - Fax:
Practice Address - Street 1:1520 10TH AVE N
Practice Address - Street 2:SUITE D
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-2069
Practice Address - Country:US
Practice Address - Phone:561-588-3477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAMI FLORIDA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable