Provider Demographics
NPI:1467063552
Name:JUAN VELEZ MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:JUAN VELEZ MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:786-355-8035
Mailing Address - Street 1:5031 N STONEHOUSE PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-9618
Mailing Address - Country:US
Mailing Address - Phone:786-355-8035
Mailing Address - Fax:520-842-2215
Practice Address - Street 1:2230 E SPEEDWAY BLVD STE 120
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4762
Practice Address - Country:US
Practice Address - Phone:786-355-8035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health