Healthcare Provider Details

I. General information

NPI: 1437566072
Provider Name (Legal Business Name): UNIVERSAL MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2014
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 NW 199TH ST
MIAMI FL
33169-2927
US

IV. Provider business mailing address

510 NW 199TH ST
MIAMI FL
33169-2927
US

V. Phone/Fax

Practice location:
  • Phone: 305-724-9497
  • Fax:
Mailing address:
  • Phone: 305-724-9497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: TY'KEASHA BROWN
Title or Position: PRESIDENT
Credential:
Phone: 305-724-9497