Organization
CHARLOTTE BEHAVIORAL HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH JAY GLYNN LMHC (CEO)
(941) 639-8300
Entity
Organization
Contact information
Practice address
1700 EDUCATION AVE, PUNTA GORDA, FL 33950-6222
(941) 639-8300
(941) 639-6831
Mailing address
1700 EDUCATION AVE, PUNTA GORDA, FL 33950-6222
(941) 639-8300
(941) 639-6831
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0808AD492200
FL
101YM0800X
Mental Health Counselor
Primary
0808AD492200
FL
1041C0700X
Clinical Social Worker
0808AD492200
FL
251S00000X
Community/Behavioral Health Agency
1477
FL
324500000X
Substance Abuse Rehabilitation Facility
2008AD4922-00-P
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060480100
—
FL
05
—
141305800
—
FL
01
—
97564
BLUE CROSS
FL
Enumeration date
01/03/2006
Last updated
05/24/2022
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