Provider Demographics
NPI:1518457126
Name:FLORIDA BEHAVIORAL CARE LLC
Entity Type:Organization
Organization Name:FLORIDA BEHAVIORAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSIKOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-490-7788
Mailing Address - Street 1:8333 W MCNAB RD STE 131
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-3203
Mailing Address - Country:US
Mailing Address - Phone:786-490-7788
Mailing Address - Fax:786-219-3883
Practice Address - Street 1:21376 MARINA COVE CIR APT 18C
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3561
Practice Address - Country:US
Practice Address - Phone:786-853-8720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-18
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)