Provider Demographics
NPI:1932638541
Name:PEGASUS BEHAVIORAL HEALTH INC
Entity Type:Organization
Organization Name:PEGASUS BEHAVIORAL HEALTH INC
Other - Org Name:SKY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-696-1121
Mailing Address - Street 1:9935 PALOMINO DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1014
Mailing Address - Country:US
Mailing Address - Phone:954-696-1121
Mailing Address - Fax:954-357-3624
Practice Address - Street 1:9935 PALOMINO DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-1014
Practice Address - Country:US
Practice Address - Phone:561-370-3867
Practice Address - Fax:561-828-5902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder