Provider Demographics
NPI:1588672885
Name:BEHAVIORAL HEALTH CARE MANAGEMENT SYSTEMS
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH CARE MANAGEMENT SYSTEMS
Other - Org Name:ENDEAVOR FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-926-6020
Mailing Address - Street 1:1939 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4516
Mailing Address - Country:US
Mailing Address - Phone:954-926-6020
Mailing Address - Fax:954-926-6362
Practice Address - Street 1:2917 N PINE HILLS RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-3539
Practice Address - Country:US
Practice Address - Phone:407-521-6141
Practice Address - Fax:407-521-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277387OtherAMERIGROUP ID NUMBER
FL274913OtherHARMONY ID NUMBER