| Shaping Lives Behavioral Health Llc | |
|
7600 S Red Rd Ste 208 South Miami FL 33143-5408 | |
| (305) 345-3751 | |
| Not Available |
| Full Name | Shaping Lives Behavioral Health Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 7600 S Red Rd Ste 208, South Miami, Florida |
| Authorized Official Name and Position | Carlos Ortiz (PRESIDENT) |
| Authorized Official Contact | 3053453751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaping Lives Behavioral Health Llc 7742 N Kendall Dr # 422 Miami FL 33156-7523 Ph: (786) 598-7171 | Shaping Lives Behavioral Health Llc 7600 S Red Rd Ste 208 South Miami FL 33143-5408 Ph: (305) 345-3751 |
| NPI Number | 1942789516 |
|---|---|
| Provider Enumeration Date | 08/14/2018 |
| Last Update Date | 02/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942789516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH15356 (Florida) | Primary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
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