Provider Demographics
NPI:1376138156
Name:WELLMIND MANAGEMENT, LLC
Entity Type:Organization
Organization Name:WELLMIND MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:MS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ BORGES
Authorized Official - Suffix:
Authorized Official - Credentials:CBHCMS
Authorized Official - Phone:786-499-2332
Mailing Address - Street 1:433 SW 86TH AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-1484
Mailing Address - Country:US
Mailing Address - Phone:786-499-2332
Mailing Address - Fax:
Practice Address - Street 1:900 W 49TH ST STE 536
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3442
Practice Address - Country:US
Practice Address - Phone:786-703-8971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management