Provider Demographics
NPI:1467446724
Name:THE JEROME GOLDEN CENTER FOR BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:THE JEROME GOLDEN CENTER FOR BEHAVIORAL HEALTH, INC.
Other - Org Name:OAKWOOD CENTER OF THE PALM BEACHES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:AR SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TRUMAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-789-0329
Mailing Address - Street 1:1041 45TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2402
Mailing Address - Country:US
Mailing Address - Phone:561-383-5736
Mailing Address - Fax:561-383-5922
Practice Address - Street 1:1041 45TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2402
Practice Address - Country:US
Practice Address - Phone:561-383-5736
Practice Address - Fax:561-383-5922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3980283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060324400Medicaid
FL060324403Medicaid
FL060324404Medicaid
FL060324406Medicaid
FL060324401Medicaid
FL060324408Medicaid
FL060324410Medicaid
FL060324412Medicaid
FL060324404Medicaid
FL104008Medicare Oscar/Certification