Provider Demographics
NPI:1063223469
Name:MEDI MENTAL HEALTH COMMUNITY INC
Entity type:Organization
Organization Name:MEDI MENTAL HEALTH COMMUNITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA CABANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-306-4995
Mailing Address - Street 1:8370 W FLAGLER ST STE 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2038
Mailing Address - Country:US
Mailing Address - Phone:786-306-4995
Mailing Address - Fax:
Practice Address - Street 1:8370 W FLAGLER ST STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2038
Practice Address - Country:US
Practice Address - Phone:786-306-4995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health