Provider Demographics
NPI:1821473000
Name:A-1 MEDICAL AND BEHAVIORAL MANAGEMENT SVC
Entity Type:Organization
Organization Name:A-1 MEDICAL AND BEHAVIORAL MANAGEMENT SVC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP-C
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, ARNP
Authorized Official - Phone:727-218-8961
Mailing Address - Street 1:2822 54TH AVE S
Mailing Address - Street 2:# 215
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-4610
Mailing Address - Country:US
Mailing Address - Phone:727-218-8961
Mailing Address - Fax:727-499-9886
Practice Address - Street 1:2822 54TH AVE S
Practice Address - Street 2:# 215
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-4610
Practice Address - Country:US
Practice Address - Phone:727-218-8961
Practice Address - Fax:727-499-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP91670433104A0630X, 314000000X, 320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness