Provider Demographics
NPI:1992905079
Name:NEW HAVEN MENTAL HEALTH CENTER
Entity type:Organization
Organization Name:NEW HAVEN MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES-GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-948-3593
Mailing Address - Street 1:2040 NE 163RD ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4951
Mailing Address - Country:US
Mailing Address - Phone:305-948-3593
Mailing Address - Fax:305-948-3594
Practice Address - Street 1:2040 NE 163RD ST
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4951
Practice Address - Country:US
Practice Address - Phone:305-948-3593
Practice Address - Fax:305-948-3594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8392261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center