Organization
EBH SERVICES OF FLORIDA
Active
Parent organization
DAVID A SACK MD TN PC
Other names
Lucida Treatment Center Prof
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID A SACK MD TN PC
Authorized official
CHERYL MAPLESDEN CPC, CHC, CHPC (DIRECTOR, REVENUE CYCLE)
(615) 510-3708
Entity
Organization
Contact information
Practice address
112 N OAK ST, SUITE 109, LANTANA, FL 33462-3260
(561) 337-2600
Mailing address
PO BOX 670521, DALLAS, TX 75267-0521
(615) 567-7282
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME110917
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP1688752
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP3156662
FL
364SF0001X
Family Health Clinical Nurse Specialist
RN9366620
FL
Other
Enumeration date
02/24/2016
Last updated
05/05/2016
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