Provider Demographics
NPI:1932602455
Name:MENTAL HEALTH FIRST
Entity Type:Organization
Organization Name:MENTAL HEALTH FIRST
Other - Org Name:MENTAL HEALTH FIRST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:VONETES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-595-0900
Mailing Address - Street 1:4700 MILLENIA BLVD STE 175
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6015
Mailing Address - Country:US
Mailing Address - Phone:407-595-0900
Mailing Address - Fax:866-480-9482
Practice Address - Street 1:4700 MILLENIA BLVD STE 175
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-6015
Practice Address - Country:US
Practice Address - Phone:407-595-0900
Practice Address - Fax:866-480-9482
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALDEVO ENTERPRISE CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-11
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7432489101YM0800X
FL7000371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G18000032780OtherFICTITIOUS NAME REGISTRATION NUMBER
FLP18000022056OtherCORPORATION NUMBER