Provider Demographics
NPI:1487018214
Name:BEHAVIORAL HEALTH SERVICES OF FLORIDA CORP
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SERVICES OF FLORIDA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:VICENTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MSMIS
Authorized Official - Phone:305-826-3256
Mailing Address - Street 1:17333 NW 62ND PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4502
Mailing Address - Country:US
Mailing Address - Phone:305-826-3256
Mailing Address - Fax:
Practice Address - Street 1:17333 NW 62ND PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4502
Practice Address - Country:US
Practice Address - Phone:305-826-3256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health