Provider Demographics
NPI:1013265404
Name:APOPKA BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:APOPKA BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:407-880-0290
Mailing Address - Street 1:1655 E SEMORAN BLVD STE 14
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5629
Mailing Address - Country:US
Mailing Address - Phone:407-880-0290
Mailing Address - Fax:407-880-0291
Practice Address - Street 1:1655 E SEMORAN BLVD STE 14
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5629
Practice Address - Country:US
Practice Address - Phone:407-880-0290
Practice Address - Fax:407-880-0291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8768251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health