# THE SHINE AGE A & L MENTAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841887320
- **Authorized official:** ALEJO CARMENATES (PRESIDENT)
- **Authorized official phone:** (786) 327-2957

## Contact information

- **Practice address:** 175 FONTAINEBLEAU BLVD STE 1N6, MIAMI, FL 33172-4511
- **Practice address phone:** (863) 277-2957
- **Mailing address:** 175 FONTAINEBLEAU BLVD STE 1N6, MIAMI, FL 33172-4511
- **Mailing address phone:** (863) 277-2957

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/30/2020
- **Last updated:** 12/30/2020