Provider Demographics
NPI:1295965234
Name:HARMONY MENTAL HEALTH AND BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:HARMONY MENTAL HEALTH AND BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-297-7505
Mailing Address - Street 1:PO BOX 585509
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32858-5509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:407-292-1804
Practice Address - Street 1:6021 WEDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-5443
Practice Address - Country:US
Practice Address - Phone:321-297-7505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8246251S00000X
FL1-05-2284251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL691610496Medicaid
FL691610498Medicaid