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General NPI Number Information
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NPI Number | 1447448741
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Entity Type | Organization
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Legal Business Name | CONEXUS CMHC LLC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 4800 W FLAGLER ST SUITE 218
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City | CORAL GABLES
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State | FL
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Zip | 33134-1446
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Country | US
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Telephone | 786-566-3696
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 W FLAGLER ST SUITE 218
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City | CORAL GABLES
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State | FL
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Zip | 33134-1446
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Country | US
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Telephone | 786-566-3696
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAGALY ORTIZ
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Credential | LCSW
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Telephone | 786-566-3696
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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 | SW8424
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License Number State | FL
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