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General NPI Number Information
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NPI Number | 1992905079
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Entity Type | Organization
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Legal Business Name | NEW HAVEN MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 2040 NE 163RD ST SUITE 208
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-4951
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Country | US
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Telephone | 305-948-3593
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Fax | 305-948-3594
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Provider Business Mailing Address
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Address Line | 2040 NE 163RD ST SUITE 208
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-4951
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Country | US
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Telephone | 305-948-3593
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Fax | 305-948-3594
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Authorized Official
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Title or Position | DIRECTOR
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Name | BARBARA MORALES-GEORGE
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Credential | LMHC
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Telephone | 305-948-3593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MH8392
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License Number State | FL
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