Provider Demographics
NPI:1649406042
Name:FAMILY BEHAVIOR SERVICES
Entity Type:Organization
Organization Name:FAMILY BEHAVIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:GRISEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-263-7925
Mailing Address - Street 1:221 W HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5441
Mailing Address - Country:US
Mailing Address - Phone:305-890-1487
Mailing Address - Fax:954-458-2428
Practice Address - Street 1:221 W HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5441
Practice Address - Country:US
Practice Address - Phone:305-890-1487
Practice Address - Fax:954-458-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management