Psi Behavioral Health, Llc

LBN: Psi Behavioral Health, Llc
Psi Behavioral Health, Llc is an health care organization with primary practice located at 3890 Dunn Ave Sutie 1104, Jacksonville FL 32218-6428. The organization recently has 4 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Public Health or Welfare, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Agencies / Public Health or Welfare is the primary health care specialty. Psi Behavioral Health, Llc can be contacted via phone (904) 723-6049, or through Wallace, Ricky via phone (904) 723-6049.

Contact Information

Primary practice address
3890 Dunn Ave Sutie 1104 Jacksonville FL 32218-6428
Phone: (904) 723-6049
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Ricky
Phone: (904) 723-6049

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Agencies / Public Health or Welfare 251K00000X
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X Florida

Profile Details

NPI number 1154762284
LBN Legal business name Psi Behavioral Health, Llc
DBA Doing business as
Authorized official Wallace, Ricky
Entity Organization
Organization subpart 1 No
Enumeration date Jul 17th, 2013
Last updated Jul 29th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154762284 NPPES
Florida MEDICAID 009163800

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