| Elder Life Mental Health Inc | |
|
18140-18142 S.w. 97th Avenue Palmetto Bay FL 33157 | |
| (786) 830-4316 | |
| Not Available |
| Full Name | Elder Life Mental Health Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 18140-18142 S.w. 97th Avenue, Palmetto Bay, Florida |
| Authorized Official Name and Position | Betsy Guevara Ruiz (PRESIDENT) |
| Authorized Official Contact | 7868304316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elder Life Mental Health Inc 18140-18142 S.w. 97th Avenue Palmetto Bay FL 33157 Ph: (786) 830-4316 | Elder Life Mental Health Inc 18140-18142 S.w. 97th Avenue Palmetto Bay FL 33157 Ph: (786) 830-4316 |
| NPI Number | 1003581240 |
|---|---|
| Provider Enumeration Date | 08/10/2021 |
| Last Update Date | 07/20/2022 |
| Certification Date | 07/11/2022 |
| Medicare PECOS PAC ID | 2163803347 |
|---|---|
| Medicare Enrollment ID | O20220719002769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003581240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Yezid A Arango |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700853132 PECOS PAC ID: 2163444043 Enrollment ID: I20051221000329 |
| Provider Name | Leslie A Santoyo Jiminez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972961787 PECOS PAC ID: 8022316942 Enrollment ID: I20160408001953 |
| Provider Name | Menar Wahood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033578190 PECOS PAC ID: 7416241732 Enrollment ID: I20190130000387 |
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