# BYBROOK BEHAVIORAL HEALTH SERVICES, PA

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

## Provider details

- **NPI number:** 1851060495
- **Authorized official:** MR. ROAN EMANUEL FORGIE PMHNP-BC (PRESIDENT)
- **Authorized official phone:** (646) 591-4970

## Contact information

- **Practice address:** 3065 DANIELS RD \# 1077, WINTER GARDEN, FL 34787-7002
- **Practice address phone:** (352) 661-1677
- **Practice address fax:** (407) 278-4062
- **Mailing address:** 3065 DANIELS RD \# 1077, WINTER GARDEN, FL 34787-7002
- **Mailing address phone:** (352) 661-1677
- **Mailing address fax:** (407) 278-4062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2021
- **Last updated:** 09/08/2021