Organization
TARGETED CM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS ROBAINA (PRESIDENT)
(786) 666-0418
Entity
Organization
Contact information
Practice address
2300 W 84TH ST, SUITE 204, HIALEAH, FL 33016-5770
(786) 666-0418
Mailing address
2300 W 84TH ST, SUITE 204, HIALEAH, FL 33016-5770
(786) 666-0418
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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