Provider Demographics
NPI:1326614033
Name:PACIFIC MENTAL HEALTH INC
Entity Type:Organization
Organization Name:PACIFIC MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMERY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVEZ HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-850-1349
Mailing Address - Street 1:8180 NW 36TH ST STE 217
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6653
Mailing Address - Country:US
Mailing Address - Phone:305-850-1349
Mailing Address - Fax:
Practice Address - Street 1:8180 NW 36TH ST STE 217
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6653
Practice Address - Country:US
Practice Address - Phone:305-850-1349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health