Basic Information
| Provider Information | |||||||||
| NPI: | 1922119098 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEHAVIORAL HEALTH INSTITUTE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1881 UNIVERSITY DR | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543400888 | ||||||||
| FaxNumber: | 9543460909 | ||||||||
| Practice Location | |||||||||
| Address1: | 1881 UNIVERSITY DR | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543400888 | ||||||||
| FaxNumber: | 9543460909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 07/06/2011 | ||||||||
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| AuthorizedOfficialLastName: | BRODBECK | ||||||||
| AuthorizedOfficialFirstName: | LESLIE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9543400888 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.