| Shaping Lives Behavioral Health Of Monroe, Llc. | |
|
103400 Overseas Hwy Ste 208 Key Largo FL 33037-2848 | |
| (305) 345-3751 | |
| Not Available |
| Full Name | Shaping Lives Behavioral Health Of Monroe, Llc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 103400 Overseas Hwy Ste 208, Key Largo, 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 Of Monroe, Llc. 10145 Overseas Highway #224 Key Largo FL 33037 Ph: (305) 345-3751 | Shaping Lives Behavioral Health Of Monroe, Llc. 103400 Overseas Hwy Ste 208 Key Largo FL 33037-2848 Ph: (305) 345-3751 |
| NPI Number | 1306325147 |
|---|---|
| Provider Enumeration Date | 08/13/2018 |
| Last Update Date | 03/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306325147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH15356 (Florida) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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