Provider Demographics
NPI:1992370175
Name:SANTANA QUALITY CARE INC
Entity Type:Organization
Organization Name:SANTANA QUALITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLEIDYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-768-9985
Mailing Address - Street 1:1501 SW 154TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2644
Mailing Address - Country:US
Mailing Address - Phone:786-768-9985
Mailing Address - Fax:
Practice Address - Street 1:1501 SW 154TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33194-2644
Practice Address - Country:US
Practice Address - Phone:786-768-9985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)