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General NPI Number Information
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NPI Number | 1376138156
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Entity Type | Organization
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Legal Business Name | WELLMIND MANAGEMENT, LLC
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 900 W 49TH ST STE 536
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City | HIALEAH
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State | FL
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Zip | 33012-3442
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Country | US
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Telephone | 786-703-8971
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Fax |
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Provider Business Mailing Address
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Address Line | 433 SW 86TH AVE APT 205
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-1484
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Country | US
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Telephone | 786-499-2332
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Fax |
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Authorized Official
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Title or Position | MGRM
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Name | MS. ALINA DIAZ BORGES
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Credential | CBHCMS
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Telephone | 786-499-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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