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
15818 SW WARFIELD BLVD, INDIANTOWN, FL 34956-3513
(772) 597-0411
(772) 597-0412
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
914478100
91 - MEDICAID
FL
Enumeration date
09/09/2021
Last updated
09/09/2021
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