NPIMap

Organization Active NPI

Suncoast Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Okeechobee, FL
National Provider Identifier
1124695960
Registry record updated Jun 9, 2021
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
SUNCOAST MENTAL HEALTH CENTER, INC.
Practice address
408 NW 3Rd St
Okeechobee, FL 34972-4129
Phone
(863) 824-0030
Fax
(863) 824-0024
NPI assigned
Jun 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Authorized official

Name
Michaelene Reese
Title
Credentialing Coordinator
Phone
(772) 489-4726

Specialties & licenses 1

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

Addresses

Primary practice location

408 NW 3Rd St
Okeechobee, FL 34972-4129

Mailing address

2222 Colonial Rd Ste 100
Fort Pierce, FL 34950-5309
Phone (772) 489-4726

Other identifiers 1

IdentifierTypeStateIssuer
910818102MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Suncoast Mental Helath13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

408 NW 3rd St
Okeechobee, FL 34972
Phone (863) 824-0030

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1124695960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 COLONIAL RD STE 100",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349505309",
            "telephone_number": "772-489-4726",
            "fax_number": "772-466-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 NW 3RD ST",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349724129",
            "telephone_number": "863-824-0030",
            "fax_number": "863-824-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "MICHAELENE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "772-489-4726"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910818102",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.