Provider Demographics
NPI:1447598370
Name:BEHAVIORAL HEALTH MANAGEMENT SVCS, INC.
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH MANAGEMENT SVCS, INC.
Other - Org Name:BAYCARE LIFE MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, HOSPITAL DIVISION
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:TREMONTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-462-7868
Mailing Address - Street 1:PO BOX 403974
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-3974
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 640
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6383
Practice Address - Country:US
Practice Address - Phone:813-872-7582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000896310Medicaid