| Legacy Behavioral Health Center Inc | |
|
518 Sw Prima Vista Blvd Port Saint Lucie FL 34983-8734 | |
| (772) 873-8811 | |
| (772) 873-8800 |
| Full Name | Legacy Behavioral Health Center Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 518 Sw Prima Vista Blvd, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Alicia B. Pajares (PRESIDENT) |
| Authorized Official Contact | 5617227866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Behavioral Health Center Inc 2640 Forest Hill Blvd West Palm Beach FL 33406-5931 Ph: (561) 616-8411 | Legacy Behavioral Health Center Inc 518 Sw Prima Vista Blvd Port Saint Lucie FL 34983-8734 Ph: (772) 873-8811 |
| NPI Number | 1942977426 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 08/24/2021 |
| Certification Date | 08/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942977426 | NPI | - | NPPES |
| 076140103 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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