Organization
HOMESTEAD BEHAVIORAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIDELYN LOPEZ (CEO)
(305) 248-3488
Entity
Organization
Contact information
Practice address
654 NE 9TH PL, HOMESTEAD, FL 33030-4934
(305) 248-3488
(305) 248-6558
Mailing address
654 NE 9TH PL, HOMESTEAD, FL 33030-4934
(305) 248-3488
(305) 248-6558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
HCC 4035
FL
103K00000X
Behavior Analyst
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
HCC4181
FL
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
HCC4181
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000350100
—
FL
05
—
002005600
—
FL
05
—
018520000
—
FL
05
—
260257100
—
FL
05
—
678856400
—
FL
Enumeration date
06/30/2006
Last updated
09/29/2021
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