Provider Demographics
NPI:1033888060
Name:ASSOCIATES MENTAL SERVICES, LLC
Entity Type:Organization
Organization Name:ASSOCIATES MENTAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-808-0632
Mailing Address - Street 1:740 W MAIN ST UNIT 8
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-4119
Mailing Address - Country:US
Mailing Address - Phone:863-438-4533
Mailing Address - Fax:863-884-1447
Practice Address - Street 1:740 W MAIN ST UNIT 8
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4119
Practice Address - Country:US
Practice Address - Phone:863-438-4533
Practice Address - Fax:863-884-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health