LEGACY BEHAVIORAL HEALTH CENTER, INC (NPI# 1003057407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003057407 |
| Entity Type | Organization |
| Organization Name | LEGACY BEHAVIORAL HEALTH CENTER, INC |
| Practice Address |
15818 Sw Warfield Blvd Indiantown FL 34956-3513 |
| Practice Telephone | 7725910411 |
| Practice Fax Number | 7725910412 |
| Mailing Telephone | 7725910411 |
| Mailing Fax Number | 7725910412 |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2009-03-13 |
| Authorized Official Name | MRS. HEIDY HERRERA GARCIA (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 7725970411 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | ========= | FL | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043501018 | Legacy Behavioral Health Center, Inc | Case Management | 835 Azalea Ln, Apt. 11, Vero Beach, FL 32963-4900 | 2011-04-26 |
| 1477828887 | Legacy Behavioral Health Center, Inc | Social Worker | 1945 22nd Ave, Vero Beach, FL 32960-3083 | 2012-03-19 |
| Street Address |
15818 SW WARFIELD BLVD |
| City | INDIANTOWN |
| State | FL |
| Zip Code | 34956-3513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659357903 | Alicia B. Pajares | Social Worker | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2005-12-19 |
| 1710525878 | Elridge Fitzgerald Alexander I | Counselor | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2019-12-19 |
| 1366080509 | Kassandra Rosa | Case Manager/Care Coordinator | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2019-12-18 |
| 1306481668 | Hamilton Merilus | Counselor | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2019-11-11 |
| 1295377026 | Natalie J Madden | Counselor | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2019-10-14 |
| 1184270019 | Amanda Kay Madden | Counselor | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2019-08-15 |
| 1174083653 | Alexis King | Case Manager/Care Coordinator | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2019-03-21 |
| 1528537115 | Aprilanne A Arwood | Counselor | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2018-11-13 |
| 1861905937 | Maria Eugenia Valls | Case Manager/Care Coordinator | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2017-11-13 |
| 1932626678 | Corina Istanich | Counselor | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2017-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003398454 | Lawrence Anton Feriozzi | Counselor | 15818 Sw Warfield Blvd, Indiantown, FL 34956 | 2018-09-02 |
| 1871087544 | Karen Deborah Smith | Nurse Practitioner | 15208 Sw Palm Oak Dr, Indiantown, FL 34956 | 2018-06-18 |
| 1710130273 | John Pasquale | Occupational Therapist | 15440 Sw Palm Drive, Indiantown, FL 34956 | 2008-10-28 |
| 1477755684 | Susan Darsann Driscoll | Nurse Practitioner | 16407 Sw Farms Road, Indiantown, FL 34956 | 2007-06-01 |
| 1033216494 | Ronald S. Limoli Sr. | Dentist | 15275 S.w. Adams St., Indiantown, FL 34956 | 2006-09-20 |
| 1437128675 | Robert J. Trenschel | Family Medicine | 15858 S.w. Warfield Blvd., Box 457, Indiantown, FL 34956-0457 | 2006-03-17 |
| 1740382829 | Asha K Kornegay | Nurse Practitioner | 15858 Sw Warfield Blvd., Indiantown, FL 34956-0648 | 2006-09-01 |
| 1821057613 | Tammy L. Tuchel | Family Medicine | 15858 S. W. Warfield Blvd., Indiantown, FL 34956-0648 | 2006-03-21 |
| 1043241375 | Michael F Gervasi | Family Medicine | 15858 Sw Warfield Blvd, Box 648, Indiantown, FL 34956-0648 | 2006-07-05 |
| 1205886223 | Florida Community Health Centers Inc | Dentist | 15858 S.w. Warfield Blvd., Indiantown, FL 34956-0648 | 2006-05-11 |
| Find all providers in zip 34956 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265909287 | Alas Family Support Center Inc | Community/Behavioral Health | 16652 Sw Warfield Blvd, Indiantown, FL 34956-4407 | 2018-10-29 |
| 1902121767 | Ana Iris Valencia | Community/Behavioral Health | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 | 2010-04-05 |
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| 1952902611 | Tallon Medical Center Inc | Community/Behavioral Health | 5600 Sw 135th Ave Ste 110, Miami, FL 33183-5125 | 2020-11-07 |
| 1356942288 | Sol Community Center, Corp | Community/Behavioral Health | 8550 W Flagler St Ste 118, Miami, FL 33144-2037 | 2020-11-06 |
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| 1235739806 | Twins Medical Services Corp | Community/Behavioral Health | 4051 E 8th Ave Ste 5, Hialeah, FL 33013-2800 | 2020-10-31 |
| 1558961110 | Family Evolution Mental Health Care Inc | Community/Behavioral Health | 2500 Nw 79th Ave Ste 255, Doral, FL 33122-1087 | 2020-10-31 |
| 1538769534 | Psycare LLC | Community/Behavioral Health | 10740 W Flagler St Ste 112, Miami, FL 33174-4405 | 2020-10-28 |
| 1508466533 | Exceptional Healthcare Services Corp | Community/Behavioral Health | 13240 N Cleveland Ave Ste 1, North Fort Myers, FL 33903-4855 | 2020-10-28 |
| 1417556903 | Genesis Community Mental Health LLC | Community/Behavioral Health | 6043 Nw 167th St Ste A10, Hialeah, FL 33015-4322 | 2020-10-26 |
| 1871192328 | Wellness Community & Medical Center Inc | Community/Behavioral Health | 946 E 25th St, Hialeah, FL 33013-3404 | 2020-10-25 |
| Find all providers with the same taxonomy | ||||
| City | INDIANTOWN |
| Zip Code | 34956 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.