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General NPI Number Information
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NPI Number | 1073148482
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Entity Type | Organization
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Legal Business Name | NUEVA VIDA COMMUNITY MENTAL HEALTH, INC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 890 SW 87TH AVE STE 10
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City | MIAMI
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State | FL
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Zip | 33174-3245
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Country | US
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Telephone | 786-344-3430
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Fax |
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Provider Business Mailing Address
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Address Line | 890 SW 87TH AVE STE 10
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City | MIAMI
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State | FL
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Zip | 33174-3245
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Country | US
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Telephone | 786-344-3430
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENNY REYES
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Credential |
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Telephone | 786-942-3537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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