# SMA HEALTHCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SMA HEALTHCARE INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598431512
- **Legal business name:** SMA HEALTHCARE INC
- **Authorized official:** MR. IVAN COSIMI (CEO)
- **Authorized official phone:** (386) 236-1811

## Contact information

- **Practice address:** 301 JUSTICE LN, BUNNELL, FL 32110-4487
- **Practice address phone:** (800) 539-4228
- **Mailing address:** 150 MAGNOLIA AVE, DAYTONA BEACH, FL 32114-4304
- **Mailing address phone:** (386) 236-3215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 08/19/2021
- **Last updated:** 08/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100348100 | — | FL |