Active NPI
Life Well Behavioral Health Center, Inc.
- Community/Behavioral Health Agency
- Doral, FL
National Provider Identifier
1619360641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- LIFE WELL BEHAVIORAL HEALTH CENTER, INC.
- Practice address
- 2801 NW 87TH Ave Ste 7
Doral, FL 33172-1604 - Phone
- (786) 717-6881
- Fax
- (786) 717-6355
- NPI assigned
- Mar 16, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lianet Gonzalez
- Title
- President
- Phone
- (786) 759-8995
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
2801 NW 87TH Ave Ste 7
Doral, FL 33172-1604
Mailing address
2801 NW 87TH Ave Ste 7
Doral, FL 33172-1604
Phone (786) 717-6881
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019851500 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
2801 NW 87th Ave
Ste 7
Doral, FL 33172
Phone (305) 653-5155
Networks
- HealthSun Health Plans Network
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Hialeah, FL
- NPI 1750758116
-
- Social Worker
- Miami, FL
- NPI 1881051456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426464000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629072000000",
"number": "1619360641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 NW 87TH AVE STE 7",
"city": "DORAL",
"state": "FL",
"postal_code": "331721604",
"telephone_number": "786-717-6881",
"fax_number": "786-717-6355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 NW 87TH AVE STE 7",
"city": "DORAL",
"state": "FL",
"postal_code": "331721604",
"telephone_number": "786-717-6881",
"fax_number": "786-717-6355"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE WELL BEHAVIORAL HEALTH CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-16",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A",
"authorized_official_last_name": "GONZALEZ",
"authorized_official_first_name": "LIANET",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "786-759-8995"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019851500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.