Healthcare Provider Details

I. General information

NPI: 1013670025
Provider Name (Legal Business Name): ELLEORHIM MENTAL WELLBEING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20348 NW 2ND AVE
MIAMI FL
33169-2503
US

IV. Provider business mailing address

20523 NW 8TH AVE
MIAMI GARDENS FL
33169-2381
US

V. Phone/Fax

Practice location:
  • Phone: 786-930-4031
  • Fax:
Mailing address:
  • Phone: 786-223-1744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIE CARLINE OSEH
Title or Position: PMHNP
Credential: APRN
Phone: 786-223-1744