Healthcare Provider Details

I. General information

NPI: 1962344465
Provider Name (Legal Business Name): SSF BEHAVIORAL SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 W 49TH ST
HIALEAH FL
33012-3606
US

IV. Provider business mailing address

635 W 49TH ST
HIALEAH FL
33012-3606
US

V. Phone/Fax

Practice location:
  • Phone: 305-202-0308
  • Fax:
Mailing address:
  • Phone: 305-202-0308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: CARMEN MELENDEZ
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 305-202-0308