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Organization
SHAPING LIVES BEHAVIORAL HEALTH LLC
Active
Organization
SHAPING LIVES BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS ORTIZ (PRESIDENT)
(305) 345-3751
Entity
Organization
Contact information
Practice address
7600 S RED RD STE 208, SOUTH MIAMI, FL 33143-5408
(305) 345-3751
Mailing address
7742 N KENDALL DR # 422, MIAMI, FL 33156-7523
(786) 598-7171
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH15356
FL
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
08/14/2018
Last updated
02/27/2019
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