Axis Behavioral Health, Inc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

9050 Issued in FL

Legal business name

AXIS BEHAVIORAL HEALTH, INC

Practice address

6840 Bird Road
Miami, FL 33155

Phone

(305) 668-0634

Fax

(305) 551-1210

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Loriana M Novoa, ED.O

Title

President

Phone

(305) 668-0634

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Axis Behavioral Health ADC Doing business as

Locations

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861614992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 BIRD ROAD",
            "address_2": "SUITE 205",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33155",
            "telephone_number": "305-668-0634",
            "fax_number": "305-551-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 BIRD ROAD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33155",
            "telephone_number": "305-668-0634",
            "fax_number": "305-551-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOVOA",
        "authorized_official_first_name": "LORIANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-668-0634",
        "authorized_official_credential": "ED.O"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "FL",
            "license": "9050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "235271",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "60-70164",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axis Behavioral Health ADC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Miami, FL
• Custodial Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.