Organization
LUCKY SOULS COMMUNITY MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA BASTARDO (AMBR)
(305) 965-4404
Entity
Organization
Contact information
Practice address
7811 CORAL WAY STE 137, MIAMI, FL 33155-6540
(305) 965-4404
Mailing address
7811 CORAL WAY STE 137, MIAMI, FL 33155-6540
(305) 965-4404
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/15/2020
Last updated
02/15/2020
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