Provider Demographics
NPI:1164006631
Name:QUALITY HEALTH MENTAL SERVICES LLC
Entity Type:Organization
Organization Name:QUALITY HEALTH MENTAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GISSELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-240-4727
Mailing Address - Street 1:11055 SW 186TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6843
Mailing Address - Country:US
Mailing Address - Phone:305-240-4727
Mailing Address - Fax:
Practice Address - Street 1:11055 SW 186TH ST STE 301
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6843
Practice Address - Country:US
Practice Address - Phone:305-240-4727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty