Provider Demographics
NPI:1497892731
Name:ACCESS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ACCESS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-469-3500
Mailing Address - Street 1:1221 W LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1857
Mailing Address - Country:US
Mailing Address - Phone:850-469-3519
Mailing Address - Fax:850-469-3661
Practice Address - Street 1:3298 SUMMIT BLVD
Practice Address - Street 2:SUITE 12
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-8318
Practice Address - Country:US
Practice Address - Phone:850-469-3519
Practice Address - Fax:850-469-3661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015030400Medicaid