Provider Demographics
NPI:1902274582
Name:QUANTUM BEHAVIORAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:QUANTUM BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHURCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-621-3896
Mailing Address - Street 1:100 S MILITARY TRL
Mailing Address - Street 2:# 19
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-3015
Mailing Address - Country:US
Mailing Address - Phone:954-621-3896
Mailing Address - Fax:954-621-3897
Practice Address - Street 1:100 S MILITARY TRL
Practice Address - Street 2:# 19
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-3015
Practice Address - Country:US
Practice Address - Phone:954-621-3896
Practice Address - Fax:954-621-3897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-12
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder