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General NPI Number Information
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NPI Number | 1124034798
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Entity Type | Organization
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Legal Business Name | TRINITY CMHC INC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 6175 NW 153RD ST SUITE 205
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2435
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Country | US
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Telephone | 786-546-7801
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Fax | 305-512-5390
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Provider Business Mailing Address
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Address Line | 6175 NW 153RD ST STE 205
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2435
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Country | US
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Telephone | 786-546-7801
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Fax | 305-512-5390
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Authorized Official
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Title or Position | CEO
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Name | MRS. SARAI NAMMUR
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Credential | LMHC
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Telephone | 786-546-7801
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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 | 605171-8
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License Number State | FL
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