NPIMap

Organization Active NPI

Elder Life Mental Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Palmetto Bay, FL
National Provider Identifier
1003581240
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ELDER LIFE MENTAL HEALTH INC
Practice address
18140-18142 S.W. 97TH Avenue
Palmetto Bay, FL 33157
Phone
(786) 830-4316
NPI assigned
Aug 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Betsy Guevara Ruiz
Title
President
Phone
(786) 830-4316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

18140-18142 S.W. 97TH Avenue
Palmetto Bay, FL 33157

Mailing address

18140-18142 S.W. 97TH Avenue
Palmetto Bay, FL 33157
Phone (786) 830-4316

National Provider Directory

National Provider Directory

Locations

2414 Coral Way
Fl 1
Coral Gables, FL 33145

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1003581240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18140-18142 S.W. 97TH AVENUE",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "33157",
            "telephone_number": "786-830-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18140-18142 S.W. 97TH AVENUE",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "33157",
            "telephone_number": "786-830-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDER LIFE MENTAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-10",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "GUEVARA RUIZ",
        "authorized_official_first_name": "BETSY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-830-4316"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.