Healthcare Provider Details

I. General information

NPI: 1982267738
Provider Name (Legal Business Name): BEHAVIORAL WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 N WATERWAY DR STE B
MIAMI FL
33155-2808
US

IV. Provider business mailing address

4800 W FLAGLER ST STE 107
CORAL GABLES FL
33134-1400
US

V. Phone/Fax

Practice location:
  • Phone: 786-470-9404
  • Fax:
Mailing address:
  • Phone:
  • 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 Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OHILDA SANCHEZ
Title or Position: OWNER
Credential:
Phone: 786-470-9404