Provider Demographics
NPI:1386787133
Name:MENTAL HEALTH CTR. OF ENGLEWOOD, INC
Entity type:Organization
Organization Name:MENTAL HEALTH CTR. OF ENGLEWOOD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:941-475-8392
Mailing Address - Street 1:1460 S MCCALL RD
Mailing Address - Street 2:SUITE 1 A
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4864
Mailing Address - Country:US
Mailing Address - Phone:941-475-8392
Mailing Address - Fax:941-475-4132
Practice Address - Street 1:1460 S MCCALL RD
Practice Address - Street 2:SUITE 1 A
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4864
Practice Address - Country:US
Practice Address - Phone:941-475-8392
Practice Address - Fax:941-475-4132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty