Organization
LA LUZ MENTAL HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE GALAN (CEO)
(305) 582-4807
Entity
Organization
Contact information
Practice address
12700 SW 128TH ST STE 108, MIAMI, FL 33186-5378
(786) 732-0865
(786) 732-0972
Mailing address
3402 SW 89TH AVE, MIAMI, FL 33165-4238
(305) 582-4807
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/25/2021
Last updated
11/17/2023
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