Provider Demographics
NPI:1306469481
Name:MELVILLE'S BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MELVILLE'S BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELVIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MELVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-692-3015
Mailing Address - Street 1:424 45TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2924
Mailing Address - Country:US
Mailing Address - Phone:401-609-3015
Mailing Address - Fax:
Practice Address - Street 1:2464 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2907
Practice Address - Country:US
Practice Address - Phone:401-692-3015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty