Provider Demographics
NPI:1558695122
Name:CENTER FOR BEHAVIORAL SOLUTIONS
Entity Type:Organization
Organization Name:CENTER FOR BEHAVIORAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JO MYRTHO
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-632-1983
Mailing Address - Street 1:434 WESTTREE LN
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1863
Mailing Address - Country:US
Mailing Address - Phone:954-632-1983
Mailing Address - Fax:954-653-2965
Practice Address - Street 1:950 S PINE ISLAND RD
Practice Address - Street 2:A-150
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3918
Practice Address - Country:US
Practice Address - Phone:954-632-1983
Practice Address - Fax:954-653-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8948104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH8948OtherPROVIDER LICENSE NUMBER