NPIMap

Organization Active NPI

Family Love Behavioral Health Care LLC

  • Behavior Analyst
  • Cutler Bay, FL
National Provider Identifier
1194249912
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
FAMILY LOVE BEHAVIORAL HEALTH CARE LLC
Practice address
18901 SW 106TH Ave Ste a-227
Cutler Bay, FL 33157-7661
Phone
(786) 732-7516
NPI assigned
Aug 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Authorized official

Name
Ketty M Huerta PerezNPI 1972027704
Title
President
Phone
(786) 732-7516

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

18901 SW 106TH Ave Ste a-227
Cutler Bay, FL 33157-7661

Mailing address

18901 SW 106TH Ave Ste a-227
Cutler Bay, FL 33157-7661
Phone (786) 732-7516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200410002128 FL Part A Provider - Home Health Agency 5193154243 Practice locations: Miami, FL

Home health agency certification: CCN 687088

Legal name
FAMILY LOVE BEHAVIORAL HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 22, 2021
Last certification
Feb 22, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jul 17, 2017 in FL
Enrollment address
18901 SW 106TH Ave
Ste A227
Miami, FL 33157-7661

Care Compare: Home health agency

Medicare Care Compare
Listed as
Family Love Behavioral Health Care LLCCCN 687088
Ownership
Proprietary
Certified
Feb 22, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ketty Huerta Perez Individual 5% Or Greater Direct Ownership Interest Jul 17, 2017 50%
Corporate OfficerPresident/Administraor Jul 17, 2017 50%
Corporate DirectorPresident/Administraor Jul 17, 2017 50%
W-2 Managing EmployeePresident/Administraor Jul 17, 2017 50%
Operational/Managerial ControlPresident/Administraor Jul 17, 2017 50%
Mario Estevez Individual Corporate OfficerAlt Admin and Don Apr 1, 2019 50%
Corporate DirectorAlt Admin and Don Apr 1, 2019 50%
W-2 Managing EmployeeAlt Admin and Don Apr 1, 2019 50%
Operational/Managerial ControlAlt Admin and Don Apr 1, 2019 50%
Nurdennis Pena Individual 5% Or Greater Direct Ownership Interest Jul 17, 2017 50%
Corporate OfficerVP Jul 17, 2017
Corporate DirectorVP Jul 17, 2017
W-2 Managing EmployeeVP Jul 17, 2017
Operational/Managerial ControlVP Jul 17, 2017 50%

Practitioners & affiliated clinicians

Practitioners 2

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": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1194249912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18901 SW 106TH AVE STE A-227",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331577661",
            "telephone_number": "786-732-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18901 SW 106TH AVE STE A-227",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331577661",
            "telephone_number": "786-732-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LOVE BEHAVIORAL HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "HUERTA PEREZ",
        "authorized_official_first_name": "KETTY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-732-7516"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

Verify at the official NPI Registry.