Randolph G. Russ
LBN: Randolph G. Russ
Randolph G. Russ is an health care organization with primary practice located at 8461 Lake Worth Rd Suite 120, Lake Worth FL 33467-2474. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty.
Randolph G. Russ can be contacted via phone (561) 201-7180, or through Russ, Randolph Graham via phone (561) 201-7180.
Contact Information
Primary practice address
8461 Lake Worth Rd Suite 120
Lake Worth FL 33467-2474
Phone: (561) 201-7180
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X |
Profile Details
| NPI number | 1548625007 |
|---|---|
| LBN Legal business name | Randolph G. Russ |
| DBA Doing business as | |
| Authorized official | Russ, Randolph Graham |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 28th, 2015 |
| Last updated | Aug 2nd, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548625007 | NPPES |
| Florida | MEDICAID | 000094200 | |
| Florida | MEDICAID | 102043700 |
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