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General NPI Number Information
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NPI Number | 1437927019
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Entity Type | Organization
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Legal Business Name | CIRCLE OF LIFE MENTAL HEALTH CARE INC
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Dates
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Enumeration Date | 12/13/2023
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 2100 CORAL WAY STE 502
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City | MIAMI
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State | FL
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Zip | 33145-2657
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Country | US
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Telephone | 786-963-0128
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 CORAL WAY STE 502
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City | MIAMI
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State | FL
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Zip | 33145-2657
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Country | US
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Telephone | 786-963-0128
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDER COPETE CASTANO
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Credential |
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Telephone | 786-909-3271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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