Provider Demographics
NPI:1972148294
Name:MESA HEALTH SERVICES INC
Entity Type:Organization
Organization Name:MESA HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:COSSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-322-1954
Mailing Address - Street 1:13810 SW 162ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1953
Mailing Address - Country:US
Mailing Address - Phone:305-322-1954
Mailing Address - Fax:
Practice Address - Street 1:13205 SW 137TH AVE STE 126
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5334
Practice Address - Country:US
Practice Address - Phone:305-322-1954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health