Provider Demographics
NPI:1376111393
Name:AAA MENTAL HEALTH AND COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:AAA MENTAL HEALTH AND COMMUNITY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-631-5197
Mailing Address - Street 1:8591 NW SOUTH RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7426
Mailing Address - Country:US
Mailing Address - Phone:305-562-4396
Mailing Address - Fax:
Practice Address - Street 1:8591 NW SOUTH RIVER DR
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-7426
Practice Address - Country:US
Practice Address - Phone:305-562-4396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty