Total Behavioral Therapy Inc. | |
2455 Hollywood Blvd Ste 211 Hollywood FL 33020-6605 | |
(954) 453-1154 | |
Not Available |
Full Name | Total Behavioral Therapy Inc. |
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Speciality | Community/Behavioral Health |
Location | 2455 Hollywood Blvd Ste 211, Hollywood, Florida |
Authorized Official Name and Position | Ivan Romero (PRESIDENT) |
Authorized Official Contact | 9547403452 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Total Behavioral Therapy Inc. 2455 Hollywood Blvd Ste 211 Hollywood FL 33020-6605 Ph: (954) 453-1154 | Total Behavioral Therapy Inc. 2455 Hollywood Blvd Ste 211 Hollywood FL 33020-6605 Ph: (954) 453-1154 |
NPI Number | 1891407789 |
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Provider Enumeration Date | 12/22/2022 |
Last Update Date | 12/22/2022 |
Certification Date | 12/22/2022 |
Medicare PECOS PAC ID | 9234592031 |
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Medicare Enrollment ID | O20230828000374 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891407789 | NPI | - | NPPES |
1659737559 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Jeffrey M Bishop |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235192659 PECOS PAC ID: 1557347333 Enrollment ID: I20220328002262 |
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