| Therapeutic Alliance Community Mental Health Center Inc | |
|
6405 Nw 36th St Suite 100 Virginia Gardens FL 33166-6974 | |
| (305) 871-3131 | |
| (305) 871-2727 |
| Full Name | Therapeutic Alliance Community Mental Health Center Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6405 Nw 36th St, Virginia Gardens, Florida |
| Authorized Official Name and Position | Dayra L Bodan (PRESIDENT) |
| Authorized Official Contact | 3058713131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Alliance Community Mental Health Center Inc 6405 Nw 36th St Suite 100 Virginia Gardens FL 33166-6974 Ph: (305) 871-3131 | Therapeutic Alliance Community Mental Health Center Inc 6405 Nw 36th St Suite 100 Virginia Gardens FL 33166-6974 Ph: (305) 871-3131 |
| NPI Number | 1447295761 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 03/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447295761 | NPI | - | NPPES |
| AD431 | Other | FL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | HCC7230 (Florida) | Primary |
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