Provider Demographics
NPI:1396253613
Name:MIAMI LAKES BEHAVIORAL SERVICES CORP
Entity type:Organization
Organization Name:MIAMI LAKES BEHAVIORAL SERVICES CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATISTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LMHC
Authorized Official - Phone:786-907-4921
Mailing Address - Street 1:6001 NW 153RD STREET
Mailing Address - Street 2:SUITE 157
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014
Mailing Address - Country:US
Mailing Address - Phone:786-907-4921
Mailing Address - Fax:
Practice Address - Street 1:6001 NW 153RD STREET
Practice Address - Street 2:SUITE 157
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:786-907-4921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty