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Organization
LEGACY BEHAVIORAL HEALTH CENTER INC
Active
Organization
LEGACY BEHAVIORAL HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA B. PAJARES LCSW (PRESIDENT)
(561) 722-7866
Entity
Organization
Contact information
Practice address
518 SW PRIMA VISTA BLVD, PORT SAINT LUCIE, FL 34983-8734
(772) 873-8811
(772) 873-8800
Mailing address
2640 FOREST HILL BLVD, WEST PALM BEACH, FL 33406-5931
(561) 616-8411
(561) 616-8412
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
914478103
91 - MEDICAID
FL
Enumeration date
08/24/2021
Last updated
08/24/2021
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