Provider Demographics
NPI:1558876714
Name:ALLIANCE BEHAVIORAL CMHC, LLC
Entity Type:Organization
Organization Name:ALLIANCE BEHAVIORAL CMHC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-250-5874
Mailing Address - Street 1:13200 SW 128TH ST STE F1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5831
Mailing Address - Country:US
Mailing Address - Phone:786-250-5874
Mailing Address - Fax:786-429-3889
Practice Address - Street 1:13200 SW 128TH ST STE F1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5831
Practice Address - Country:US
Practice Address - Phone:786-250-5874
Practice Address - Fax:786-429-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)