Healthcare Provider Details

I. General information

NPI: 1538705751
Provider Name (Legal Business Name): LARKIN BEHAVIOR HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 NW 77TH CT STE 401
HIALEAH GARDENS FL
33016-2073
US

IV. Provider business mailing address

10550 NW 77TH CT STE 401
HIALEAH GARDENS FL
33016-2073
US

V. Phone/Fax

Practice location:
  • Phone: 786-332-3340
  • Fax: 305-603-9875
Mailing address:
  • Phone: 786-332-3340
  • Fax: 305-603-9875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JESUS ROJAS OLAZABAL
Title or Position: PRESIDENT
Credential:
Phone: 786-332-3340