MEDICARE: CARE CENTER FOR MENTAL HEALTH

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
1	251K00000X	Public Health or Welfare Agency	47162-0028802	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1780786616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE CENTER FOR MENTAL HEALTH

Provider Business Mailing Address
First Line	:	1205 4TH ST
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-3707
Country	:	US
Telephone Number	:	305-292-6843
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 4TH ST
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-3707
Country	:	US
Telephone Number	:	305-292-6843
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. MICHAEL FUNK
Credential	:	PHD
Telephone Number	:	305-292-6843

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	08/22/2020

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Directions to “CARE CENTER FOR MENTAL HEALTH ” Practice Location

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