Organization
WITHIN HEALTH PROVIDER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE STOCKERT RN (DIRECTOR OF HEALTH SERVICES)
(305) 725-2028
Entity
Organization
Contact information
Practice address
2450 COLORADO AVE STE 100E, SANTA MONICA, CA 90404-5535
(866) 918-2114
Mailing address
2665 S BAYSHORE DR STE 220, MIAMI, FL 33133-5402
(866) 918-2114
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/30/2021
Last updated
04/02/2024
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