Provider Demographics
NPI:1073148482
Name:NUEVA VIDA COMMUNITY MENTAL HEALTH, INC
Entity Type:Organization
Organization Name:NUEVA VIDA COMMUNITY MENTAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-942-3537
Mailing Address - Street 1:890 SW 87TH AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3245
Mailing Address - Country:US
Mailing Address - Phone:786-344-3430
Mailing Address - Fax:
Practice Address - Street 1:890 SW 87TH AVE STE 10
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3245
Practice Address - Country:US
Practice Address - Phone:786-344-3430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)