Provider Demographics
NPI:1740878552
Name:CYRIL, BABEFO B (CBHCM/CBHCMS)
Entity type:Individual
Prefix:
First Name:BABEFO
Middle Name:B
Last Name:CYRIL
Suffix:
Gender:M
Credentials:CBHCM/CBHCMS
Other - Prefix:
Other - First Name:BOBBY
Other - Middle Name:
Other - Last Name:CYRIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CBHCM/CBHCMS
Mailing Address - Street 1:108 SHEILA AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5771
Mailing Address - Country:US
Mailing Address - Phone:239-271-8896
Mailing Address - Fax:
Practice Address - Street 1:1219 DUNN AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2405
Practice Address - Country:US
Practice Address - Phone:239-271-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS101205251B00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management