Provider Demographics
NPI:1598932469
Name:INTEGRATED MENTAL HEALTH SERVICES, PA
Entity Type:Organization
Organization Name:INTEGRATED MENTAL HEALTH SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:RICARDO
Authorized Official - Last Name:BERRIO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-438-2172
Mailing Address - Street 1:10031 PINES BLVD
Mailing Address - Street 2:SUITE # 246
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6179
Mailing Address - Country:US
Mailing Address - Phone:954-438-2172
Mailing Address - Fax:954-438-2172
Practice Address - Street 1:10031 PINES BLVD
Practice Address - Street 2:SUITE # 246
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6179
Practice Address - Country:US
Practice Address - Phone:954-438-2172
Practice Address - Fax:954-438-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8207251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health