JBH BEHAVIORAL HEALTH SYSTEMS LLC

Provider Demographics

• NPI: 1659545978
• Name: JBH BEHAVIORAL HEALTH SYSTEMS LLC
• Entity type: Organization
• Organization Name: JBH BEHAVIORAL HEALTH SYSTEMS LLC
• Authorized Official - Title/Position: CEO
• Authorized Official - Prefix: MS
• Authorized Official - First Name: TEHJAN
• Authorized Official - Middle Name: S
• Authorized Official - Last Name: MARTIN
• Authorized Official - Credentials: RNC
• Authorized Official - Phone: 239-848-6515
• Mailing Address - Street 1: 4113 W RIVERSIDE DR
• Mailing Address - City: FORT MYERS
• Mailing Address - State: FL
• Mailing Address - Zip Code: 33901-8732
• Mailing Address - Country: US
• Mailing Address - Phone: 239-936-1114
• Mailing Address - Fax: 239-936-5968
• Practice Address - Street 1: 12550 NEW BRITTANY BLVD
• Practice Address - Street 2: SUITE 200
• Practice Address - City: FORT MYERS
• Practice Address - State: FL
• Practice Address - Zip Code: 33907-3655
• Practice Address - Country: US
• Practice Address - Phone: 239-936-1114
• Practice Address - Fax: 239-936-5968
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2008-04-17
• Last Update Date: 2008-07-16

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)