Provider Demographics
NPI:1710683891
Name:BOCA BEHAVIORAL HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:BOCA BEHAVIORAL HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-899-8868
Mailing Address - Street 1:2499 GLADES RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7260
Mailing Address - Country:US
Mailing Address - Phone:561-899-8868
Mailing Address - Fax:561-899-8720
Practice Address - Street 1:2499 GLADES RD STE 108
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7260
Practice Address - Country:US
Practice Address - Phone:561-899-8868
Practice Address - Fax:561-899-8720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty