Provider Demographics
NPI:1972280121
Name:MENTAL HEALTH SERVICES CORP
Entity Type:Organization
Organization Name:MENTAL HEALTH SERVICES CORP
Other - Org Name:SOUTHWELL HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-288-7362
Mailing Address - Street 1:1806 N FLAMINGO RD STE 347
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1040
Mailing Address - Country:US
Mailing Address - Phone:954-288-7362
Mailing Address - Fax:954-827-7680
Practice Address - Street 1:1806 N FLAMINGO RD STE 347
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1040
Practice Address - Country:US
Practice Address - Phone:954-288-7362
Practice Address - Fax:954-827-7680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health