Provider Demographics
NPI:1386426237
Name:SANDY BEHAVIORAL HEALTH INC.
Entity type:Organization
Organization Name:SANDY BEHAVIORAL HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-367-1064
Mailing Address - Street 1:12905 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2905
Mailing Address - Country:US
Mailing Address - Phone:786-367-1064
Mailing Address - Fax:
Practice Address - Street 1:12905 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2905
Practice Address - Country:US
Practice Address - Phone:786-367-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)