Provider Demographics
NPI:1811417694
Name:ALEA THERAPEUTIC BEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:ALEA THERAPEUTIC BEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEA GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-291-3979
Mailing Address - Street 1:8500 SW 109TH AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4455
Mailing Address - Country:US
Mailing Address - Phone:786-291-3979
Mailing Address - Fax:
Practice Address - Street 1:9715 SW 155TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3831
Practice Address - Country:US
Practice Address - Phone:786-291-3979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health