# COMMUNITY BEHAVIORAL MANAGEMENT,INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083966642
- **Authorized official:** DR. LIDICE GISEL CARRILLO BS,FMD (TARGETED CASE MANAGER/PRESIDENT)
- **Authorized official phone:** (786) 230-5396

## Contact information

- **Practice address:** 3 SW 129TH AVE STE 203, PEMBROKE PINES, FL 33027-1779
- **Practice address phone:** (786) 230-5396
- **Practice address fax:** (786) 431-1491
- **Mailing address:** 9440 NW 35TH CT, MIAMI, FL 33147-2730
- **Mailing address phone:** (786) 230-5396
- **Mailing address fax:** (786) 431-1491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/07/2012
- **Last updated:** 02/19/2022