Provider Demographics
NPI:1740744390
Name:ASC COMMUNITY MENTAL HEALTH CORP
Entity Type:Organization
Organization Name:ASC COMMUNITY MENTAL HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:
Authorized Official - First Name:ZANNIA
Authorized Official - Middle Name:FABIOLA
Authorized Official - Last Name:FALERO VIGOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-768-0184
Mailing Address - Street 1:2460 SW 137TH AVE STE 254
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6399
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2460 SW 137TH AVE STE 254
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6399
Practice Address - Country:US
Practice Address - Phone:786-768-0184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)