| Vivify D & P Community Mental Health Care Inc | |
|
7420 Sw 48th St Ste A Miami FL 33155-4415 | |
| (786) 755-2615 | |
| Not Available |
| Full Name | Vivify D & P Community Mental Health Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7420 Sw 48th St Ste A, Miami, Florida |
| Authorized Official Name and Position | Odalys Diaz Perez (PRESIDENT) |
| Authorized Official Contact | 7863339460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivify D & P Community Mental Health Care Inc 7420 Sw 48th St Ste A Miami FL 33155-4415 Ph: (786) 755-2615 | Vivify D & P Community Mental Health Care Inc 7420 Sw 48th St Ste A Miami FL 33155-4415 Ph: (786) 755-2615 |
| NPI Number | 1093301335 |
|---|---|
| Provider Enumeration Date | 12/20/2020 |
| Last Update Date | 12/20/2020 |
| Certification Date | 12/20/2020 |
| Medicare PECOS PAC ID | 1850792862 |
|---|---|
| Medicare Enrollment ID | O20210629000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093301335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Anouk Herrera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659737559 PECOS PAC ID: 8123417128 Enrollment ID: I20211112001314 |
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