Healthcare Provider Details

I. General information

NPI: 1699482927
Provider Name (Legal Business Name): MEI CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15920 SW 252ND ST
HOMESTEAD FL
33031-2000
US

IV. Provider business mailing address

15920 SW 252ND ST
HOMESTEAD FL
33031-2000
US

V. Phone/Fax

Practice location:
  • Phone: 867-082-7177
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
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: MARIETA GARCIA DE PORTO
Title or Position: PRESIDENT
Credential: LMHC, BCBA
Phone: 786-708-2717