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Organization
KMG BEHAVIORAL HEALTH SERVICES LLC
Active
Organization
KMG BEHAVIORAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRUDI JUSTICE (PRESIDENT)
(561) 927-9442
Entity
Organization
Contact information
Practice address
15165 MICHELANGELO BLVD APT 207, DELRAY BEACH, FL 33446-6026
(561) 927-9442
Mailing address
1601-1 N MAIN ST UNIT 3159, JACKSONVILLE, FL 32206-7707
(561) 927-9442
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
Other
Enumeration date
01/10/2023
Last updated
10/26/2023
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