Provider Demographics
NPI:1669187241
Name:PRO-HEALTH BEHAVIORAL CENTER CORPORATION
Entity type:Organization
Organization Name:PRO-HEALTH BEHAVIORAL CENTER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEIDYS
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ-CHUMACEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-796-4324
Mailing Address - Street 1:13205 SW 137TH AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5335
Mailing Address - Country:US
Mailing Address - Phone:786-732-6298
Mailing Address - Fax:786-732-6278
Practice Address - Street 1:13205 SW 137TH AVE STE 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5335
Practice Address - Country:US
Practice Address - Phone:786-732-6298
Practice Address - Fax:786-732-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty