Provider Demographics
NPI:1982293924
Name:ANGELITO MENTAL HEALTH CORP.
Entity Type:Organization
Organization Name:ANGELITO MENTAL HEALTH CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-839-9053
Mailing Address - Street 1:7950 NW 155TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5819
Mailing Address - Country:US
Mailing Address - Phone:786-744-8431
Mailing Address - Fax:786-744-8432
Practice Address - Street 1:7950 NW 155TH ST STE 108
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5819
Practice Address - Country:US
Practice Address - Phone:786-744-4381
Practice Address - Fax:786-744-4382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health