MEDICARE: LEBT MENTAL HEALTH LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

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	:	1932841665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEBT MENTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	1220 W 62ND ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-6319
Country	:	US
Telephone Number	:	786-458-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 W 49TH ST STE 739
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2824
Country	:	US
Telephone Number	:	786-458-7100
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. ENRIQUE BARREIRO
Credential	:
Telephone Number	:	786-302-8472

Provider Enumeration Date	:	04/12/2022
Last Update Date	:	11/27/2024

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Directions to “LEBT MENTAL HEALTH LLC ” Practice Location

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