Healthcare Provider Details

I. General information

NPI: 1568835791
Provider Name (Legal Business Name): AGENCY OF MENTAL HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W 84TH ST STE 104
HIALEAH FL
33016-5771
US

IV. Provider business mailing address

8878 NW 187TH ST
HIALEAH FL
33018-6281
US

V. Phone/Fax

Practice location:
  • Phone: 305-903-3168
  • Fax: 786-666-0472
Mailing address:
  • Phone: 305-903-3168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MR. BERNARDO REYES
Title or Position: PRESIDENT
Credential: LMHC
Phone: 305-903-3168