Provider Demographics
NPI:1992338081
Name:JK MENTAL HEALTH INC
Entity type:Organization
Organization Name:JK MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JAQUELINA
Authorized Official - Middle Name:KARINA
Authorized Official - Last Name:KOPYTKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-277-9936
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR STE 205B
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4709
Mailing Address - Country:US
Mailing Address - Phone:786-277-9936
Mailing Address - Fax:
Practice Address - Street 1:1380 NE MIAMI GARDENS DR STE 205B
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4709
Practice Address - Country:US
Practice Address - Phone:786-277-9936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)