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NPI Code Detail

MEDICARE: SAFE MENTAL BEHAVIOR WELLNESS COMMUNITY CORP

MEDICARE: SAFE MENTAL BEHAVIOR WELLNESS COMMUNITY CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QP2300XPrimary Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609407204
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFE MENTAL BEHAVIOR WELLNESS COMMUNITY CORP
Provider Business Mailing Address
First Line : 4751 W 4TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3938
Country : US
Telephone Number : 305-713-5536
Fax Number :
Provider Business Practice Location Address
First Line : 4751 W 4TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3938
Country : US
Telephone Number : 305-713-5536
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DANIEL C. CRUZ
Credential :
Telephone Number : 786-796-1200
Provider Enumeration Date : 02/01/2020
Last Update Date : 06/16/2023

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Directions to “SAFE MENTAL BEHAVIOR WELLNESS COMMUNITY CORP ” Practice Location

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