Legacy Mental & Wellness Health Group Corp

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LEGACY MENTAL & WELLNESS HEALTH GROUP CORP

Practice address

4005 NW 114TH Ave Unit 8
Doral, FL 33178-4372

Phone

(786) 816-0908

Fax

(786) 999-8805

NPI assigned

Sep 2, 2026

Organization subpart

No

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

Authorized official

Name

Ernesto Guevara, APRN

Title

Owner

Phone

(786) 816-0908

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1114836533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 NW 114TH AVE UNIT 8",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784372",
            "telephone_number": "786-816-0908",
            "fax_number": "786-999-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 NW 114TH AVE UNIT 8",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784372",
            "telephone_number": "786-816-0908",
            "fax_number": "786-999-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MENTAL & WELLNESS HEALTH GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "GUEVARA",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-816-0908",
        "authorized_official_credential": "APRN"
    },
    "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": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Doral, FL
• Providers in Doral, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.