Provider Demographics
NPI:1255737458
Name:TOTAL FAMILY BEHAVIORAL GROUP, INC.
Entity type:Organization
Organization Name:TOTAL FAMILY BEHAVIORAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:9544-321-7676
Mailing Address - Street 1:1000 N HIATUS RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3097
Mailing Address - Country:US
Mailing Address - Phone:954-431-7676
Mailing Address - Fax:888-538-2226
Practice Address - Street 1:4420 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-1819
Practice Address - Country:US
Practice Address - Phone:954-431-7676
Practice Address - Fax:888-538-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-15
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health