Healthcare Provider Details

I. General information

NPI: 1144838681
Provider Name (Legal Business Name): SALAS THERAPY MENTAL HEALTH SERVICES, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 11/16/2024
Certification Date: 11/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15946 SW 147TH LN
MIAMI FL
33196-5731
US

IV. Provider business mailing address

15946 SW 147TH LN
MIAMI FL
33196-5731
US

V. Phone/Fax

Practice location:
  • Phone: 786-205-4058
  • Fax:
Mailing address:
  • Phone: 786-205-4058
  • Fax:

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: ALDO YOE SALAS
Title or Position: PRESIDENT
Credential: LMFT
Phone: 786-205-4058