Provider Demographics
NPI:1497060149
Name:SAFE HARBOR MENTAL HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:SAFE HARBOR MENTAL HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEL CUETO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:786-290-3812
Mailing Address - Street 1:6401 SW 87TH AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2500
Mailing Address - Country:US
Mailing Address - Phone:305-279-8400
Mailing Address - Fax:305-279-8404
Practice Address - Street 1:6401 SW 87TH AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2500
Practice Address - Country:US
Practice Address - Phone:305-279-8400
Practice Address - Fax:305-279-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0004242101YM0800X
FLMH0005546101YM0800X
FLPY5934103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty