Provider Demographics
NPI:1457094658
Name:PEPPER BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:PEPPER BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:561-856-3934
Mailing Address - Street 1:2328 10TH AVE N STE 103
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6612
Mailing Address - Country:US
Mailing Address - Phone:561-856-3934
Mailing Address - Fax:
Practice Address - Street 1:2328 10TH AVE N STE 103
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-6612
Practice Address - Country:US
Practice Address - Phone:561-856-3934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty