| Success Mental Health Services Corp | |
|
9839 Pines Blvd Pembroke Pines FL 33024-6100 | |
| (305) 833-9602 | |
| Not Available |
| Full Name | Success Mental Health Services Corp |
|---|---|
| Speciality | Counselor |
| Location | 9839 Pines Blvd, Pembroke Pines, Florida |
| Authorized Official Name and Position | Miguel Labrada Padron (PRESIDENT) |
| Authorized Official Contact | 3058339602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Success Mental Health Services Corp 9839 Pines Blvd Pembroke Pines FL 33024-6100 Ph: (305) 833-9602 | Success Mental Health Services Corp 9839 Pines Blvd Pembroke Pines FL 33024-6100 Ph: (305) 833-9602 |
| NPI Number | 1124621263 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 10/31/2024 |
| Certification Date | 10/31/2024 |
| Medicare PECOS PAC ID | 2860889862 |
|---|---|
| Medicare Enrollment ID | O20220421001005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124621263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251B00000X | Case Management | (* (Not Available)) | Secondary |
| Provider Name | Adam Evans |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417101411 PECOS PAC ID: 8921263112 Enrollment ID: I20160122001076 |
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