| Pediatric Behavioral Health Associates, Inc. | |
|
5818 Se Agnew Rd Belleview FL 34420-4020 | |
| (561) 715-5910 | |
| Not Available |
| Full Name | Pediatric Behavioral Health Associates, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 5818 Se Agnew Rd, Belleview, Florida |
| Authorized Official Name and Position | Nicole Woller (PRESIDENT) |
| Authorized Official Contact | 5617061004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Behavioral Health Associates, Inc. 2735 Se 140th Pl Summerfield FL 34491-2877 Ph: (561) 715-5910 | Pediatric Behavioral Health Associates, Inc. 5818 Se Agnew Rd Belleview FL 34420-4020 Ph: (561) 715-5910 |
| NPI Number | 1174385470 |
|---|---|
| Provider Enumeration Date | 01/23/2024 |
| Last Update Date | 03/20/2024 |
| Certification Date | 03/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174385470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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