Provider Demographics
NPI:1942097092
Name:L & L MENTAL MEDICAL & SOCIAL SERVICES CENTER
Entity type:Organization
Organization Name:L & L MENTAL MEDICAL & SOCIAL SERVICES CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LIHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNDORA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-830-2984
Mailing Address - Street 1:710 E 9TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4571
Mailing Address - Country:US
Mailing Address - Phone:786-830-2984
Mailing Address - Fax:
Practice Address - Street 1:710 E 9TH ST APT 105
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4571
Practice Address - Country:US
Practice Address - Phone:786-830-2984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health