Provider Demographics
NPI:1831484666
Name:SUNCOAST BEHAVIORAL LLC
Entity Type:Organization
Organization Name:SUNCOAST BEHAVIORAL LLC
Other - Org Name:SUN COAST BEHAVIORAL INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:TURICZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-677-6700
Mailing Address - Street 1:12012 BOYETTE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5631
Mailing Address - Country:US
Mailing Address - Phone:813-677-6700
Mailing Address - Fax:
Practice Address - Street 1:12012 BOYETTE RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5631
Practice Address - Country:US
Practice Address - Phone:813-677-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)