Provider Demographics
NPI:1922119098
Name:BEHAVIORAL HEALTH INSTITUTE INC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRODBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-340-0888
Mailing Address - Street 1:1881 UNIVERSITY DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071
Mailing Address - Country:US
Mailing Address - Phone:954-340-0888
Mailing Address - Fax:954-346-0909
Practice Address - Street 1:1881 UNIVERSITY DR
Practice Address - Street 2:SUITE 104
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071
Practice Address - Country:US
Practice Address - Phone:954-340-0888
Practice Address - Fax:954-346-0909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24843Medicare PIN