Provider Network. County: Alachua. Family Preservation Services of FL (CMHC) Community Mental Health Centers. Camelot Community Care Inc (CMHC)

Transcription

1 Network County: Alachua Family Preservation Services of FL (CMHC) Community Mental Health Centers Camelot Community Care Inc (CMHC) 2233 Nw 41st St Suite 700 F Gainesville, FL County: Alachua Medicaid No: Phone: (352) (850) CDS Family & Behavioral Health (CMHC) 3615 SW 13th Street Suite 4 Gainesville, FL County: Alachua Medicaid No: NOF Phone: (352) (352) Childrens Home Society (CMHC) 711 NW 1st St Gainesville, FL County: Alachua Medicaid No: Phone: (866) NW 6th Street Suite A 1 Gainesville, FL County: Alachua Medicaid No: Phone: (352) (352) LAWRENCE ADU (MD) 103 SW2nd Avenue Gainesville, FL County: Alachua Medicaid No: Phone: (352) (352) Jing Liu (MD) 6500 W Newberry Road Gainesville, FL County: Alachua Medicaid No: Psychiatrists Phone: (352) (352) Wednesday, December 09, 2015 Page 1 of 134

2 Network County: Bay County: Brevard Community Mental Health Centers Community Mental Health Centers Childrens Home Society (CMHC) Childrens Home Society (CMHC) 914 Harrison Ave Panama City, FL County: Bay Medicaid No: Phone: (850) (850) Croton Road Melbourne, FL County: Brevard Medicaid No: Phone: (321) (321) Florida Therapy Services Inc (CMHC) Circles of Care Inc (CMHC) 2711 W. 15th Street Panama City, FL County: Bay Medicaid No: Phone: (850) (850) Cedar Street Rockledge, FL County: Brevard Medicaid No: Phone: (321) Hospitals/Clinics Emerald Coast Behavioral Hospital (HOSP) 1940 Harrison Avenue Panama City, FL County: Bay Medicaid No: Phone: (850) (850) Circles of Care Inc (CMHC) 2000 Commerce Dr Melbourne, FL County: Brevard Medicaid No: Phone: (321) (321) Wednesday, December 09, 2015 Page 2 of 134

3 Network Circles of Care Inc (CMHC) Circles of Care Inc (CMHC) 2020 Commerce Dr Melbourne, FL County: Brevard Medicaid No: Phone: (321) South Washington Ave Titusville, FL County: Brevard Medicaid No: Phone: (321) Circles of Care Inc (CMHC) Circles of Care Inc (CMHC) 400 East Sheridan Rd Melbourne, FL County: Brevard Medicaid No: Phone: (321) Airport Rd. Melbourne, FL County: Brevard Medicaid No: Phone: (321) Circles of Care Inc (CMHC) Coastal Mental Health Center (CMHC) 4450 West Eau Gallie Blvd Suite 200 Melbourne, FL County: Brevard Medicaid No: Phone: (321) Bougainvillea Dr. Suite A Rockledge, FL County: Brevard Medicaid No: Phone: (800) (888) Wednesday, December 09, 2015 Page 3 of 134

4 Network Coastal Mental Health Center (CMHC) Devereux Foundation Viera (CMHC) 4620 Lipscomb St Suite 3 Palm Bay, FL County: Brevard Medicaid No: Phone: (800) (888) Devereux Drive Melbourne, FL County: Brevard Medicaid No: Phone: (866) (866) Devereux Foundation Brevard Grp Home for Boys (CMHC) 225 N Burnett Road Cocoa, FL County: Brevard Medicaid No: Phone: (866) (866) Impower (CMHC) 1037 Pathfinder Way Suite 130 Rockledge, FL County: Brevard Medicaid No: Phone: (321) (407) Devereux Foundation Brevard Grp Home for Girls (CMHC) 2330 Aurora Road Melbourne, FL County: Brevard Medicaid No: Phone: (866) (866) Cecilia Corrado (ARNP) Indialantic, FL Nurse Practitioner 105 S. Rivverside Drive Suite 151 County: Brevard Medicaid No: Phone: (321) (321) Psychiatrists Wednesday, December 09, 2015 Page 4 of 134

5 Network James Jacobson (MD) Devereux Foundation TCM Brevard (TCM) 2123 Franklin Dr NE Palm Bay, FL County: Brevard Medicaid No: Phone: (321) (321) Sarno Road Suite 214 Melbourne, FL County: Brevard Medicaid No: Phone: (866) (866) Beatriz Villafane (MD) 2123 Franklin Dr NE Palm Bay, FL County: Brevard Medicaid No: Phone: (321) (321) Residential Treatment Centers Therapeutic Foster Care/Specialized Therapeutic Devereux Foundation Brevard Grp Home for Boys (STFC) 225 N Burnett Road Cocoa, FL County: Brevard Medicaid No: Phone: (866) (866) Devereux Foundation Viera (RTC) 8000 Devereux Drive Melbourne, FL County: Brevard Medicaid No: Phone: (866) (866) Devereux Foundation Brevard Grp Home for Girls (STFC) 2330 Aurora Road Melbourne, FL County: Brevard Medicaid No: Phone: (866) (866) Targeted Case Management Wednesday, December 09, 2015 Page 5 of 134

6 Network Devereux Foundation STFC Brevard (STFC) Butterfly Effects LLC (ABA) 1600 Sarno Road Suite 214 Melbourne, FL County: Brevard Medicaid No: Phone: (866) (866) Fairway Drive Suite 300 Lighthouse Point, FL Medicaid No: Phone: (954) (954) CREOLE RUSSIAN Devereux Foundation TFC Brevard (TFC) Cadenza Center For Psychotherapy (ABA) 1600 Sarno Road Suite 214 Melbourne, FL County: Brevard Medicaid No: Phone: (866) (866) N Park Rd Suite 400 Hollywood, FL Medicaid No: NOF Phone: (954) (954) County: Broward ABA Facility Behavior Analysis Inc. (ABA) 8001 SW 36 Street Suite 9 Fort Lauderdale, FL Medicaid No: NOF Phone: (786) (305) Children's Center for Development & Behavior (ABA) 440 Sawgrass Corporate Parkway Suite 106 Sunrise, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 6 of 134

7 Network Florida Comprehensive Autism Center (ABA) Progressive Behavioral Science (ABA) 2701 WEST OAKLAND PARK BLVD SUITE 310 Oakland Park, FL Medicaid No: Phone: (954) (954) Oaks Way Suite 904 Pompano Beach, FL Medicaid No: NOF Phone: (305) (305) Integrative Methods (ABA) 556 Nw 208 Way Pembroke Pines, FL Medicaid No: Phone: (954) (954) Omega Behavioral Consulting (ABA) 7420 NW 5TH STREET Plantation, FL Medicaid No: NOF Phone: (786) Community Mental Health Centers Active Community Health Center (CMHC) 1000 N Hiatus Road Suite 140 Pembroke Pines, FL Medicaid No: Phone: (954) (954) Advance Health and Commuity Serv (CMHC) 8910 Miramar Parkway Suite 306 Miramar, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 7 of 134

8 Network Agency for Community Treatment Serv (CMHC) Banyan Community Health Center Inc (CMHC) 1104 NE 13th Street Fort Lauderdale, FL Medicaid No: Phone: (954) (954) W Oakland Park Blv Fort Lauderdale, FL Medicaid No: Phone: (305) ARC Broward (CMHC) Bayview Center for Mental Health (CMHC) Nw 53rd Street Sunrise, FL Medicaid No: Phone: (954) Hibiscus Drive Pembroke Pines, FL Medicaid No: Phone: (954) Archways Inc (CMHC) Bayview Center for Mental Health (CMHC) 919 NE 13th Street Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Poinciana Drive Pembroke Pines, FL Medicaid No: Phone: (954) Wednesday, December 09, 2015 Page 8 of 134

9 Network Bayview Center for Mental Health (CMHC) Bayview Center for Mental Health (CMHC) 8001 SW 36 Street Suite 10 Davie, FL Medicaid No: Phone: (954) South Palm Drive Pembroke Pines, FL Medicaid No: Phone: (954) Bayview Center for Mental Health (CMHC) Bougainvilla House (CMHC) 8375 South Palm Drive Pembroke Pines, FL Medicaid No: Phone: (954) SE 4th Ave Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Bayview Center for Mental Health (CMHC) Broward Community and Family Health (CMHC) 8401 South Palm Drive Pembroke Pines, FL Medicaid No: Phone: (954) Hollywood Blvd Suite 100B Hollywood, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 9 of 134

10 Network Broward County Board of County Comm (CMHC) Broward County Board of County Comm (CMHC) 1000 SW 2nd Street Fort Lauderdale, FL Medicaid No: Phone: (954) (954) NW 99th Way Coral Springs, FL Medicaid No: Phone: (954) (954) Broward County Board of County Comm (CMHC) Broward County Board of County Comm (CMHC) 1011 SW 2nd Court Fort Lauderdale, FL Medicaid No: Phone: (954) (594) SW 18th Street West Park, FL Medicaid No: Phone: (954) (594) Broward County Board of County Comm (CMHC) Camelot Community Care Inc (CMHC) 2995 North Dixie Hwy Oakland Park, FL Medicaid No: Phone: (954) (954) South Perimeter Road Suite 120 Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 10 of 134

11 Network Childrens Home Society (CMHC) Genesis Family Services LLC (CMHC) 401 NE 4th Street Ft Lauderdale, FL Medicaid No: Phone: (954) (954) Stirling Road Hollywood, FL Medicaid No: Phone: (954) (954) CMETLLC (CMHC) Global Consultancy Group (CMHC) 1527 NE 4th Ave Fort Lauderdale, FL Medicaid No: Phone: (954) (772) CREOLE 4801 S. University Drive Suite 126 Davie, FL Medicaid No: Phone: (954) (954) Floridian Behavioral Healthcare LLC (CMHC) Henderson Behavioral Health (CMHC) 4699 N Federal Hwy Suite 104 Pompano Beach, FL Medicaid No: Phone: (954) (954) Jackson Street Hollywood, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 11 of 134

12 Network Henderson Behavioral Health (CMHC) Henderson Behavioral Health (CMHC) 2677 NW 19th Street Fort Lauderdale, FL Medicaid No: Phone: (954) (954) S University Drive Suite 6 Davie, FL Medicaid No: Phone: (954) (954) Henderson Behavioral Health (CMHC) Henderson Behavioral Health (CMHC) 2900 W Prospect Rd Fort Lauderdale, FL Medicaid No: Phone: (954) (954) S. University Drive Davie, FL Medicaid No: Phone: (954) (954) Henderson Behavioral Health (CMHC) Henderson Behavioral Health (CMHC) 330 SW 27th Avenue Fort Lauderdale, FL Medicaid No: Phone: (954) (954) N. State Road 7 Building A Suite 102 Lauderdale Lakes, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 12 of 134

13 Network Henderson Behavioral Health (CMHC) Memorial Adult Outpatient Behaviora (CMHC) 4720 N State Road 7 Lauderdale Lakes, FL Medicaid No: Phone: (954) (954) N. 29th Ave Hollywood, FL Medicaid No: NOF Phone: (954) (954) Henderson Behavioral Health (CMHC) Millenium Clinic Inc (CMHC) 5700 NW 27th Court Lauderhill, FL Medicaid No: Phone: (954) (954) East Oakland Park Oakland Park, FL Medicaid No: Phone: (786) Kids in Distress Inc (CMHC) Multicultural Alliance Health Care (CMHC) 819 NE 26th Street Wilton Manors, FL Medicaid No: Phone: (954) (954) West Cypress Creek Road, Executive Court, Suite D 12 Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 13 of 134

14 Network New Direction Institute Inc (CMHC) Pacific Case Management LLC (CMHC) 1509 N State Road 7 Suite C Margate, FL Medicaid No: Phone: (954) (954) W Oakland Park Blvd Suite 107 Sunrise, FL Medicaid No: Phone: (305) (954) New Direction Institute Inc (CMHC) Parents Information and Resource Ce (CMHC) 6730 West Commerce Blvd Tamarac, FL Medicaid No: Phone: (954) (954) N. Dixie Highway Pompano Beach, FL Medicaid No: Phone: (954) (954) Our Children Our Future (CMHC) Reflections Wellness Center of Brow (CMHC) 2835 Hollywood Blvd Hollywood, FL Medicaid No: Phone: (305) (305) Stirling Road Pembroke Pines, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 14 of 134

15 Network Rega Mental Health Center (CMHC) Sunshine Social Services Inc (CMHC) 7501 Wiles Rd Suite 105 Coral Springs, FL Medicaid No: Phone: (954) (954) Wilton Drive Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Serenity Behavioral Health (CMHC) The Chrysalis Center (CMHC) 2303 Hollywood Blvd Suite 12 Hollywood, FL Medicaid No: Phone: (954) (954) W Broward Blvd Suite 100 Ft Lauderdale, FL Medicaid No: Phone: (954) (954) Smith Community Mental Health (CMHC) The Starting Place (CMHC) 601 S State Rd 7 Plantation, FL Medicaid No: Phone: (954) (954) N. State Road 7 Suite 200 Plantation, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 15 of 134

16 Network Theracare Community Center (CMHC) Fort Lauderdale Hospital (HOSP) 7481 W Oakland Park Blvd Suite 302C Tamarac, FL Medicaid No: Phone: (954) (954) E Las Olas Blvd Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Third Step Behavioral Health Care (CMHC) Jackson Long Term Care Pharmacy (CLINIC) 200 SW 27th Avenue Suite 100 Fort Lauderdale, FL Medicaid No: Phone: (954) (954) NW 174th AVE PEMBROKE PINES, FL Medicaid No: Phone: (786) CZECH SPANISH Hospitals/Clinics Atlantic Shores Hospital (HOSP) 4545 N Federal Hwy Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Larkin Community Behavioral Health (HOSP) 1201 N 37th Ave Hollywood, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 16 of 134

17 Network Memorial Hospital Miramar (HOSP) Memorial Regional Hospital (HOSP) 1901 SW 172nd Ave Miramar, FL Medicaid No: Phone: (954) N 35th Ave Suite 170 Hollywood, FL Medicaid No: Phone: (954) Memorial Hospital Pembroke (HOSP) North Shore Medical Center FMC Camp (HOSP) 7800 Sheridan St Pembroke Pines, FL Medicaid No: Phone: (954) West Oakland Park Blvd. Lauderdale Lakes, FL Medicaid No: Phone: (954) (954) Memorial Hospital West (HOSP) PHT JMH Transplant (HOSP) 703 N Flamingo Rd Pembroke Pines, FL Medicaid No: Phone: (954) S ANDREWS AVE FT LAUDERDALE, FL Medicaid No: NOF Phone: (305) CREOLE Wednesday, December 09, 2015 Page 17 of 134

18 Network University Hosp & Medical Center (HOSP) James Foster (ARNP) 7201 N University Drive Tamarac, FL Medicaid No: Phone: (954) (954) NE 26 Street Suite 102 Wilton Manors, FL Medicaid No: Phone: (954) (954) Gloria Cardozo (ARNP) Hollywood, FL Nurse Practitioner Pembroke Pines Blvd. Suite 209 Medicaid No: Phone: (954) (954) Kandace Eagle (ARNP) 1601 N Palm Ave Suite 211 Pembroke Pines, FL Medicaid No: Phone: (888) (954) Marjorie Gillespie Johnson (ARNP) 2500 N University Dr. Suite 2 Sunrise, FL Medicaid No: Phone: (954) (888) Heather Holder (ARNP) 3800 W Broward Blvd Suite 100 Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 18 of 134

19 Network Heather Holder (ARNP) Joanne Willis (ARNP) 919 NE 13th Street Fort Lauderdale, FL Medicaid No: Phone: (954) (954) N Palm Ave Suite 211 Pembroke Pines, FL Medicaid No: Phone: (888) (954) Kimberly Palazzolo (ARNP) 1601 N Palm Ave Suite 211 Pembroke Pines, FL Medicaid No: Phone: (888) (954) Kimberly Palazzolo (ARNP) 3816 Hollywood Blvd Suite 202 Hollywood, FL Medicaid No: Phone: (954) Robert Antoine (MD) Psychiatrists 2501 E Commercial Blvd Suite 211 Fort Lauderdale, FL Medicaid No: Phone: (954) (954) FRENCH SPANISH CREOLE Ashish Bhatt (MD) 1527 NE 4th Ave Fort Lauderdale, FL Medicaid No: Phone: (954) (772) Wednesday, December 09, 2015 Page 19 of 134

20 Network Jacqueline Boutrouille (MD) Serge Celestin (MD) 7880 N University Drive Suite 303 Tamarac, FL Medicaid No: Phone: (954) (954) FRENCH SPANISH 1725 N. University Drive Suite 350 Coral Springs, FL Medicaid No: Phone: (954) (954) FRENCH CREOLE Maria Cabrera (MD) Antonio DeFilippo (MD) 1601 N Palm Ave Suite 211 Pembroke Pines, FL Medicaid No: Phone: (888) (954) N University Dr Pembroke Pines, FL Medicaid No: Phone: (954) (954) Maximiliano Cardozo (MD) Richard Douyon (MD) Pembroke Pines Blvd. Suite 209 Hollywood, FL Medicaid No: Phone: (954) (954) Pines Blvd Suite 214 Pembroke Pines, FL Medicaid No: Phone: (954) (866) FRENCH Wednesday, December 09, 2015 Page 20 of 134

21 Network Jessica Evelson (MD) Paula Ann Marcelle Francis (MD) 7481 W Oakland Park Blvd Suite 100 Lauderhill, FL Medicaid No: Phone: (888) (954) N. Commerce Parkway Suite 210 Weston, FL Medicaid No: Phone: (954) (866) David Flaherty (MD) Paula Ann Marcelle Francis (MD) 7481 W Oakland Park Blvd Suite 100 Lauderhill, FL Medicaid No: Phone: (888) (954) East Commercial Blvd Suite 211 Ft Lauderdale, FL Medicaid No: Phone: (954) (866) Abraham Flemenbaum (MD) Diana Glaccum Gavagni (MD) 1000 N Hiatus Road Suite 140 Pembroke Pines, FL Medicaid No: Phone: (954) (954) HEBREW 2699 Stirling RD Suite C 105 Fort Lauderdale, FL Medicaid No: Phone: (954) (305) Wednesday, December 09, 2015 Page 21 of 134

22 Network Stephen Hubbard (DO) Mohammad Latif Jangda (MD) 1601 N Palm Ave Suite 211 Pembroke Pines, FL Medicaid No: Phone: (888) (954) N University Drive Suite 201 Tamarac, FL Medicaid No: Phone: (954) (954) URDU PUNJABI Krithika Iyer (MD) Dennis M. Liston (MD) 1601 N Palm Ave Suite 211 Pembroke Pines, FL Medicaid No: Phone: (888) (954) TAMIL 2151 E.Commercial Blvd Suite 304 Fort Lauderdale, FL Medicaid No: Phone: (954) (954) Ronald Kurlander (MD) Ignacio Lopez Merino (MD) 150 E. Sample Road Suite 100 Pompano Beach, FL Medicaid No: Phone: (954) (954) NW 4 Street Suite 304 Plantation, FL Medicaid No: Phone: (954) (954) Wednesday, December 09, 2015 Page 22 of 134

23 Network Alvaro Manotas (MD) Shlomo Pascal (MD) 817 S University Dr, Suite 120 Plantation, FL Medicaid No: Phone: (954) (954) NW 123 Ave Pembroke Pines, FL Medicaid No: Phone: (954) (954) ROMANIAN HEBREW Marino Molina (MD) Narendra Patel (MD) 1725 N. University Drive Suite 350 Coral Springs, FL Medicaid No: Phone: (954) (954) North Pine Island Rd Suite 206 Plantation, FL Medicaid No: Phone: (954) (954) Bhadresh Parikh (MD) Ely Pelta (MD) 7707 North University Drive Suite 207 Tamarac, FL Medicaid No: Phone: (954) (954) North University Drive Suite 102 Coral Springs, FL Medicaid No: Phone: (954) (954) YIDDISH PORTUGUESE Wednesday, December 09, 2015 Page 23 of 134

24 Network Patrick Pinchinat (MD) Carlos Satulovsky (MD) Pines Blvd Suite 214 Pembroke Pines, FL Medicaid No: Phone: (954) (954) FRENCH SPANISH CREOLE 300 Diplomat Parkway Apt 301 Hallandale Beach, FL Medicaid No: Phone: (786) (954) Edward Rosa (MD) Faujia Sobhan (MD) 5451 University Drive Suite 102 Coral Springs, FL Medicaid No: Phone: (954) (954) W Oakland Park Blvd Suite 100 Lauderhill, FL Medicaid No: Phone: (888) (954) BENGALI BANGLA Anna Rzadkowolsky Raoli (MD) Tanveer Sobhan (MD) 2699 Stirling RD Suite C 105 Fort Lauderdale, FL Medicaid No: Phone: (954) (305) W Oakland Park Blvd Suite 100 Lauderhill, FL Medicaid No: Phone: (888) (954) BENGALI BANGLA Wednesday, December 09, 2015 Page 24 of 134

25 Network Arun Somani (MD) Florida Palms Academy (SIPP) 9700 Stirling Road Suite 104 Hollywood, FL Medicaid No: Phone: (954) (954) Mckinley Street Hollywood, FL Medicaid No: Phone: (954) Fernando Stern (MD) 3700 Washington Street Suite 304 Hollywood, FL Medicaid No: Phone: (954) (954) Robert Vassall (MD) 9000 Sheridan Street Suite 110 Pembroke Pines, FL Medicaid No: Phone: (954) (954) Statewide Inpatient Psychiatric Programs Targeted Case Management Devereux Foundation TCM Dade (TCM) 6365 Taft Street Suite 2002 Hollywood, FL Medicaid No: Phone: (866) (866) Pickett Fences Family (TCM) 3800 Inverrary Blvd Suite 401 C Lauderhill, FL Medicaid No: Phone: (954) (888) Wednesday, December 09, 2015 Page 25 of 134

26 Network Reciprocate 1906 (TCM) Devereux Foundation TFC Broward/Dade (TFC) 3600 S State Road 7 Suite 231 Miramar, FL Medicaid No: Phone: (786) (786) Taft Street Suite 2002 Hollywood, FL Medicaid No: Phone: (866) (866) Regional Managment Care Inc (TCM) 3810 Inverrary Blvd Suite 40 A Lauderhill, FL Medicaid No: Phone: (954) (954) Therapeutic Foster Care/Specialized Therapeutic Devereux Foundation STFC Broward/Dade (STFC) 6365 Taft Street Suite 2002 Hollywood, FL Medicaid No: Phone: (866) (866) Therapeutic Group Homes Alternate Group Care Inc (TGH) SW 50TH PLACE Southwest Ranches, FL Medicaid No: Phone: (954) (954) Alternate Group Care Inc (TGH) 5050 SW 163rd Ave Weston, FL Medicaid No: Phone: (954) Wednesday, December 09, 2015 Page 26 of 134

27 Network County: Calhoun Charlotte Behavioral Health Care (CMHC) Community Mental Health Centers Florida Therapy Services Inc (CMHC) E Central Ave Blountstown, FL County: Calhoun Medicaid No: Phone: (850) (850) County: Charlotte Community Mental Health Centers 1700 Education Ave Punta Gorda, FL County: Charlotte Medicaid No: Phone: (941) (941) Southwest Florida Counseling Center (CMHC) 1777 Tamiami Trail Suite 201 Port Charlotte, FL County: Charlotte Medicaid No: Phone: (941) Charlotte Behavioral Health Care (CMHC) County: Citrus 1032 Tamiami Trl Port Charlotte, FL County: Charlotte Medicaid No: Phone: (941) (941) The Centers Inc (CMHC) 3238 South Lecanto Highway Lecanto, FL County: Citrus Medicaid No: Phone: (352) Community Mental Health Centers Psychiatrists Wednesday, December 09, 2015 Page 27 of 134

28 Network Parmanad Gurnani (MD) Clay Behavioral Health Center Inc (CMHC) 3787 E. Gulf to Lake Hwy Inverness, FL County: Citrus Medicaid No: Phone: (352) (352) URDU HINDI 3292 County Road 220 Middleburg, FL County: Clay Medicaid No: Phone: (904) (904) Sonal Parikh (MD) Clay Behavioral Health Center Inc (CMHC) 5596 West Norvell Bryant Hwy Crystal River, FL County: Citrus Medicaid No: Phone: (352) Knight Boxx Rd Orange Park, FL County: Clay Medicaid No: Phone: (904) (904) County: Clay Community Mental Health Centers Hospitals/Clinics Orange Park Medical Center (HOSP) Clay Behavioral Health Center Inc (CMHC) 1726 Kingsley Ave Suite 2 Orange Park, FL County: Clay Medicaid No: Phone: (904) (904) Kingsley Ave Orange Park, FL County: Clay Medicaid No: Phone: (904) (904) Nurse Practitioner Wednesday, December 09, 2015 Page 28 of 134

29 Network Paul Zetterower (ARNP) 3292 County Road 220 Middleburg, FL County: Clay Medicaid No: Phone: (904) (904) Psychiatrists Community Mental Health Centers Collier Health Services Inc. (CMHC) 1265 Creekside Pkwy Suite 208 Naples, FL County: Collier Medicaid No: Phone: (239) (239) Kathleen Grissett (MD) Collier Health Services Inc. (CMHC) 165 Wells Rd Suite 408 Orange Park, FL County: Clay Medicaid No: Phone: (904) Creekside St Suite 101 Naples, FL County: Collier Medicaid No: Phone: (239) (239) County: Collier Collier Health Services Inc. (CMHC) ABA Facility Every Step Counts Behavioral Therap (ABA) 8344 Laurel Lakes Blvd Naples, FL County: Collier Medicaid No: NOF Phone: (239) (239) Heritage Blvd Immokalee, FL County: Collier Medicaid No: Phone: (239) (239) Wednesday, December 09, 2015 Page 29 of 134

30 Network Collier Health Services Inc. (CMHC) Collier Health Services Inc. (CMHC) 1454 Madison Ave Immokalee, FL County: Collier Medicaid No: Phone: (239) (239) th St N Naples, FL County: Collier Medicaid No: Phone: (239) (239) Collier Health Services Inc. (CMHC) Collier Health Services Inc. (CMHC) 1755 Heritage Trail Suite A Naples, FL County: Collier Medicaid No: Phone: (239) (239) N 9th St Immokalee, FL County: Collier Medicaid No: Phone: (239) (239) Collier Health Services Inc. (CMHC) Collier Health Services Inc. (CMHC) 1755 Heritage Trl Suite B Naples, FL County: Collier Medicaid No: Phone: (239) (239) Golden Gate Pkwy Naples, FL County: Collier Medicaid No: Phone: (239) (239) Wednesday, December 09, 2015 Page 30 of 134

31 Network David Lawrence Mental Health Center (CMHC) Family Preservation Services of FL (CMHC) 2806 S Horseshoe Drive Naples, FL County: Collier Medicaid No: Phone: (239) (239) South Horseshoe Drive Unit 402 Naples, FL County: Collier Medicaid No: Phone: (239) (239) David Lawrence Mental Health Center (CMHC) Youth Haven Inc (CMHC) 425 North First Street Immokalee, FL County: Collier Medicaid No: Phone: (239) (239) Whitaker Road Naples, FL County: Collier Medicaid No: Phone: (239) (239) David Lawrence Mental Health Center (CMHC) 6075 Bathey Lane Naples, FL County: Collier Medicaid No: Phone: (239) (239) Hospitals/Clinics The Willough at Naples (HOSP) 9001 Tamiami Trail East Naples, FL County: Collier Medicaid No: Phone: (239) (239) Wednesday, December 09, 2015 Page 31 of 134

32 Network County: Columbia County: Desoto Community Mental Health Centers Community Mental Health Centers Resolutions Health Alliance PA (CMHC) Charlotte Behavioral Health Care (CMHC) 1344 SE Baya Drive Lake City, FL County: Columbia Medicaid No: Phone: (386) (386) E. Gibson St Arcadia, FL County: Desoto Medicaid No: Phone: (863) (863) Resolutions Health Alliance PA (CMHC) Family Preservation Services of FL (CMHC) 992 SW Baya Drive Lake City, FL County: Columbia Medicaid No: Phone: (386) (386) North Mills Ave Arcadia, FL County: Desoto Medicaid No: Phone: (941) (941) Wednesday, December 09, 2015 Page 32 of 134

33 Network County: Duval Child Guidance Center (CMHC) Community Mental Health Centers Camelot Community Care Inc (CMHC) 4720 Salisbury Rd Suite 127 Jacksonville, FL County: Duval Medicaid No: Phone: (904) (850) Child Guidance Center (CMHC) 1100 Cesery Blvd Suite 100 Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Child Guidance Center (CMHC) 1110 Edgewood Ave Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Lexington Ave Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Child Guidance Center (CMHC) 5776 ST Augustine Rd Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Childrens Home Society (CMHC) 3027 San Diego Road Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Wednesday, December 09, 2015 Page 33 of 134

34 Network Gateway Community Services (CMHC) Mental Health Resource Center Inc (CMHC) 555 Stockton Street Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Woodcock Drive Building 2400 Suite 105 Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Mental Health Resource Center Inc (CMHC) Mental Health Resource Center Inc (CMHC) Beach Blvd Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Emerson Street Building 5 Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Mental Health Resource Center Inc (CMHC) Mental Health Resource Center Inc (CMHC) 3333 West 20th Street Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) East Curch Sreet Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Wednesday, December 09, 2015 Page 34 of 134

35 Network Mental Health Resource Center Inc (CMHC) Northwest Behavioral Health Service (CMHC) 655 West 8TH Street Suite 4 South Pavilion Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) N Edgewood Ave Jacksonville, FL County: Duval Medicaid No: Phone: (904) (908) Mental Health Resource Center Inc (CMHC) 921 N. Davis Street Building B Suite 315 Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Northwest Behavioral Health Service (CMHC) 1400 Edgewood Ave Jacksonville, FL County: Duval Medicaid No: Phone: (904) (908) Hospitals/Clinics Memorial Hospital Jacksonville (HOSP) 3625 University Blvd South Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) River Point Behavioral Health (HOSP) 6300 Beach Blvd Jacksonville, FL County: Duval Medicaid No: Phone: (904) Wednesday, December 09, 2015 Page 35 of 134

36 Network Wekiva Springs Hospital (HOSP) Sivanta Paul (MD) 3947 Salisbury Road Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Salisbury Road Suite 301 Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Paul Zetterower (ARNP) 3625 University Blvd S Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Suhas Joshi (MD) 3625 University Blvd S Nurse Practitioner Psychiatrists Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Jorge Richardson (MD) 3625 University Blvd S Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Carlos Torrellas (MD) 4190 Belfort Road Jacksonville, FL County: Duval Medicaid No: Phone: (904) (954) Wednesday, December 09, 2015 Page 36 of 134

37 Network Lauren Williams (MD) Childrens Home Society (CMHC) 3625 University Blvd S Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) N. Palafox St Suite 103 Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Daniel Memorial Inc (SIPP) 3725 Belfort Road Jacksonville, FL County: Duval Medicaid No: Phone: (904) (904) Statewide Inpatient Psychiatric Programs Florida Therapy Services Inc (CMHC) 4400 Bayou Blvd Suite 38 Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Hospitals/Clinics County: Escambia West Florida Hospital (HOSP) Community Mental Health Centers Adult & Child Mental Health Care (CMHC) 6706 N 9th Avenue Suite B 5 Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) N Davis Highway Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Nurse Practitioner Wednesday, December 09, 2015 Page 37 of 134

38 Network Nancy Hart (ARNP) Henry Doelnan (MD) 2191 E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) North Palafox Street Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Stephen Curtis (MD) 2191 E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Vicence Dillon (MD) 1120 North Palafox Street Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Psychiatrists Julia Fernandez (MD) 2191 E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) John Fetzer (MD) 2191 E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Wednesday, December 09, 2015 Page 38 of 134

39 Network David Greenblum (MD) Shabana Jaffri (MD) 2191 E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) John Hayes (MD) Raul Jimenez (MD) 2191 E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Jian Hu (MD) Timothy Wuerz (DO) 2191 E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) E. Johnson Avenue Pensacola, FL County: Escambia Medicaid No: Phone: (850) (850) Statewide Inpatient Psychiatric Programs Wednesday, December 09, 2015 Page 39 of 134

40 Network Lakeview Center Inc (SIPP) SMA Behavioral Health Svcs(OP Svcs) (CMHC) 1221 W Lakeview Ave Pensacola, FL County: Escambia Medicaid No: Phone: (850) Justice Lane Bunnell, FL County: Flagler Medicaid No: Phone: (386) Lakeview Center Inc (SIPP) County: Franklin 1920 North J Street Pensacola, FL County: Escambia Medicaid No: Phone: (850) County: Flagler Community Mental Health Centers Coastal Mental Health Center (CMHC) Community Mental Health Centers Apalachee Center Inc. (CMHC) th Street Apalachicola, FL County: Franklin Medicaid No: Phone: (850) Florida Therapy Services Inc (CMHC) 31 Lupi Ct Suite 210 Palm Coast, FL County: Flagler Medicaid No: Phone: (800) (888) US Hwy 98 Eastpoint, FL County: Franklin Medicaid No: Phone: (850) (850) Wednesday, December 09, 2015 Page 40 of 134

41 Network County: Gadsden County: Gulf Community Mental Health Centers Community Mental Health Centers Apalachee Center Inc. (CMHC) Florida Therapy Services Inc (CMHC) 79 LaSalle Path Quincy, FL County: Gadsden Medicaid No: Phone: (850) Middle School Rd Port St Joe, FL County: Gulf Medicaid No: Phone: (850) (850) Disc Village Inc. (CMHC) County: Hernando 305B Crawford Street Quincy, FL County: Gadsden Medicaid No: Phone: (850) (850) Florida Therapy Services Inc (CMHC) 35 Martin Luther King Jr Blvd Quincy, FL County: Gadsden Medicaid No: Phone: (850) (850) Elizabeth Church (ARNP) Brooksville, FL Nurse Practitioner Hospital Blvd. Suite 100 County: Hernando Medicaid No: Phone: (352) (352) Psychiatrists Wednesday, December 09, 2015 Page 41 of 134

42 Network Hany Botros Mikhail (MD) County: Highlands Cortez Boulevad Brooksville, FL County: Hernando Medicaid No: Phone: (352) (352) Tanveer Chaudhry (MD) Hospital Blvd. Suite 100 Brooksville, FL County: Hernando Medicaid No: Phone: (352) (352) Shodhan Patel (MD) Community Mental Health Centers Tri County Human Services Inc (CMHC) 100 West College Drive Avon Park, FL County: Highlands Medicaid No: Phone: (863) (863) County: Hillsborough Community Mental Health Centers Camelot Community Care Inc (CMHC) Cortez Boulevard Brooksville, FL County: Hernando Medicaid No: Phone: (352) (352) Tech Blvd Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Wednesday, December 09, 2015 Page 42 of 134

43 Network Childrens Home Society (CMHC) Mental Health Care Inc. (CMHC) 1515 Michelin Court Lutz, FL County: Hillsborough Medicaid No: Phone: (813) (813) A Henry Avenue Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Family Preservation Services of FL (CMHC) Mental Health Care Inc. (CMHC) N 53rd Street Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) E Henry Avenue Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Mental Health Care Inc. (CMHC) Mental Health Care Inc. (CMHC) 1403 W. Reynolds Street Plant City, FL County: Hillsborough Medicaid No: Phone: (813) (813) W. Violet Street Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Wednesday, December 09, 2015 Page 43 of 134

44 Network Mental Health Care Inc. (CMHC) Mental Health Care Inc. (CMHC) 301 N. Palmer Street Plant City, FL County: Hillsborough Medicaid No: Phone: (813) (813) N. 22nd Street Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Mental Health Care Inc. (CMHC) Northside Mental Health Center Inc (CMHC) 5707 N. 22nd St Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Bruce B. Downs Blvd Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Mental Health Care Inc. (CMHC) Phoenix Houses of Florida (CMHC) 5800 Nebraka Ave Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Vonderburg Drive Suite 301 Brandon, FL County: Hillsborough Medicaid No: Phone: (813) (813) Wednesday, December 09, 2015 Page 44 of 134

45 Network Phoenix Houses of Florida (CMHC) Brandon Regional Hospital (HOSP) 5501 W. Waters Avenue Suite 406 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Oakfield Dr. Brandon, FL County: Hillsborough Medicaid No: Phone: (813) (813) The Chrysalis Center (CMHC) Memorial Hospital of Tampa (HOSP) 1228 E 7th Avenue Suite 200 Tampa, FL County: Hillsborough Medicaid No: Phone: (954) (954) Swann Avenue Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) The Chrysalis Center (CMHC) 6800 N. Dale Mabry Hwy Suite 164 Tampa, FL County: Hillsborough Medicaid No: Phone: (407) (954) Hospitals/Clinics Kathi Arbigast (ARNP) 221 Hobbs Street Suite 101 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Nurse Practitioner Wednesday, December 09, 2015 Page 45 of 134

46 Network Dorit Breiter (ARNP) Joanna Mulder (ARNP) 4107 W Spruce Street Suite 100 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) HEBREW 221 Hobbs Street Suite 101 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Kimberly Duke (ARNP) 4107 W Spruce Street Suite 100 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) William Hendrix (ARNP) 221 Hobbs Street Suite 101 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Walter Afield (MD) Tampa, FL Psychiatrists 4107 W Spruce Street Suite 100 County: Hillsborough Medicaid No: Phone: (813) (813) FRENCH ITALIAN Krishan Batra (MD) Race Track Rd Odessa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Wednesday, December 09, 2015 Page 46 of 134

47 Network Suman Bhat (MD) Ashit Vijapura (MD) 613 W. Dr. Martin Luther King Jr. B Suite 101 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) N. Alexander St Plant City, FL County: Hillsborough Medicaid No: Phone: (813) (813) Adrianus De Ruijter (MD) Ashit Vijapura (MD) 1427 Oakfield Dr. Brandon, FL County: Hillsborough Medicaid No: Phone: (813) (813) W Dr Martin Luther King Jr Blv Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (813) Alan Feldman (MD) County: Holmes 2835 W. Delon Street Suite 206 Tampa, FL County: Hillsborough Medicaid No: Phone: (813) (727) Community Mental Health Centers Florida Therapy Services Inc (CMHC) 701 E Pennsylvania Ave Bonifay, FL County: Holmes Medicaid No: Phone: (850) (850) Wednesday, December 09, 2015 Page 47 of 134

48 Network County: Indian River New Horizons of the Treasure Coast (CMHC) Community Mental Health Centers Childrens Home Society (CMHC) th St Vero Beach, FL County: Indian River Medicaid No: Phone: (772) Hibiscus Childrens Center (CMHC) Street Vero Beach, FL County: Indian River Medicaid No: Phone: (772) Legacy Behavioral Health Center (CMHC) th Avenue SW Suite 9 & 10 Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) nd Avenue Suite 202 Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) Sequelcare of Florida (CMHC) nd Avenue Suite 102 Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) Treasure Coast Community Health (CMHC) County Road Suite 512 Fellsmere, FL County: Indian River Medicaid No: Phone: (772) (772) Wednesday, December 09, 2015 Page 48 of 134

49 Network Treasure Coast Community Health (CMHC) Paul Hebig (MD) 1545 Sw 9th Street Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) Street Vero Beach, FL County: Indian River Medicaid No: Phone: (772) Treasure Coast Community Health (CMHC) Kristin Hicks (MD) 1553 US Highway 1 Suite 105 Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) th Street Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) Whole Family Health Center Inc (CMHC) Erwin Ramos (MD) th Place Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) Street Vero Beach, FL County: Indian River Medicaid No: Phone: (772) Psychiatrists Wednesday, December 09, 2015 Page 49 of 134

50 Network Erwin Ramos (MD) County: Jefferson th Street Vero Beach, FL County: Indian River Medicaid No: Phone: (772) (772) County: Jackson Community Mental Health Centers Florida Therapy Services Inc (CMHC) Community Mental Health Centers Apalachee Center Inc. (CMHC) 1996 S. Jeffreson St. Monticello, FL County: Jefferson Medicaid No: Phone: (850) Florida Therapy Services Inc (CMHC) 2944 Pennsylvania Avenue Suite L Marianna, FL County: Jackson Medicaid No: Phone: (850) (850) S Water St Monticello, FL County: Jefferson Medicaid No: Phone: (850) (850) Wednesday, December 09, 2015 Page 50 of 134

51 Network County: Lake Lifestream Behavioral Center (CMHC) Community Mental Health Centers Coastal Mental Health Center (CMHC) 734 North 3rd St Suite 105 Leesburg, FL County: Lake Medicaid No: Phone: (800) (888) Lifestream Behavioral Center (CMHC) E. 5th Street Umatilla, FL County: Lake Medicaid No: Phone: (352) (352) Lifestream Behavioral Center (CMHC) 201 Magnolia Ave Leesburg, FL County: Lake Medicaid No: Phone: (352) (352) Tally Road Leesburg, FL County: Lake Medicaid No: Phone: (352) (352) Lifestream Behavioral Center (CMHC) 2020 Tally Road Leesburg, FL County: Lake Medicaid No: Phone: (352) (352) Lifestream Behavioral Center (CMHC) 215 N. Third Street Leesburg, FL County: Lake Medicaid No: Phone: (352) (352) Wednesday, December 09, 2015 Page 51 of 134

52 Network Lifestream Behavioral Center (CMHC) Yasin Choudry (MD) 404 Webster Street Leesburg, FL County: Lake Medicaid No: Phone: (352) (352) West Dixie Avenue Leesburg, FL County: Lake Medicaid No: Phone: (352) URDU Lifestream Behavioral Center (CMHC) 655 Hwy 50 Suite 104 Clermont, FL County: Lake Medicaid No: Phone: (352) (352) Hospitals/Clinics Statewide Inpatient Psychiatric Programs National Deaf Academy LLC (SIPP) US HWY 441 Mount Dora, FL County: Lake Medicaid No: Phone: (352) (352) The Vines Hospital (HOSP) County: Lee 15 La Grande Blvd The Villages, FL County: Lake Medicaid No: Phone: (352) (352) Psychiatrists ABA Facility Peace by Piece Solutions (ABA) 6714 Winkler Avenue Fort Myers, FL County: Lee Medicaid No: NOF Phone: (239) (239) Wednesday, December 09, 2015 Page 52 of 134

53 Network Community Mental Health Centers Camelot Community Care Inc (CMHC) 5237 Summerlin Commons Blvd Fort Myers, FL County: Lee Medicaid No: Phone: (239) (850) Childrens Home Society (CMHC) 1940 Maravilla Ave Fort Myers, FL County: Lee Medicaid No: Phone: (239) DNA Comprehensive Therapy Services (CMHC) Metropolis Ave Suite 2 Fort Myers, FL County: Lee Medicaid No: Phone: (239) (239) Family Preservation Services of FL (CMHC) 2180 Maravilla Ln Fort Myers, FL County: Lee Medicaid No: Phone: (239) (239) Saluscare Inc. (CMHC) Deer Run Park Rd Fort Myers, FL County: Lee Medicaid No: Phone: (239) (239) Saluscare Inc. (CMHC) 1105 Cultural Park Blvd Cape Coral, FL County: Lee Medicaid No: Phone: (239) (239) Wednesday, December 09, 2015 Page 53 of 134