MEDICARE: BEHAVIOR & MENTAL HOPE INC

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LICENSE	OTHER	FL	2021038322

General Provider Information

NPI Number	:	1881275071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIOR & MENTAL HOPE INC

Provider Business Mailing Address
First Line	:	17670 NW 78TH AVE STE 114
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-3665
Country	:	US
Telephone Number	:	786-848-7091
Fax Number	:

Provider Business Practice Location Address
First Line	:	17670 NW 78TH AVE STE 114
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-3665
Country	:	US
Telephone Number	:	786-848-7091
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICAL
Name	:	MRS. LIEN PEREZ REYES
Credential	:
Telephone Number	:	786-848-7091

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	04/19/2021

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Directions to “BEHAVIOR & MENTAL HOPE INC ” Practice Location

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