| Golden Phoenix Mental Health Llc | |
|
2100 W 76th St Ste 201 Hialeah FL 33016-5503 | |
| (786) 353-2324 | |
| (786) 353-2863 |
| Full Name | Golden Phoenix Mental Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2100 W 76th St Ste 201, Hialeah, Florida |
| Authorized Official Name and Position | Ingrid Cruz Uguet (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7863532324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Phoenix Mental Health Llc 8051 W 24th Ave Ste 11 Hialeah FL 33016-5596 Ph: (786) 353-2324 | Golden Phoenix Mental Health Llc 2100 W 76th St Ste 201 Hialeah FL 33016-5503 Ph: (786) 353-2324 |
| NPI Number | 1861080319 |
|---|---|
| Provider Enumeration Date | 01/08/2021 |
| Last Update Date | 10/07/2024 |
| Certification Date | 10/07/2024 |
| Medicare PECOS PAC ID | 8628472453 |
|---|---|
| Medicare Enrollment ID | O20210802001315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861080319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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