Organization
JACKSON BEHAVIORAL & CASE MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICIO LOPEZ (MANAGER)
(954) 496-1667
Entity
Organization
Contact information
Practice address
5877 SW 123RD AVE, MIAMI, FL 33183-1525
(954) 496-1667
Mailing address
9140 SW 156TH CT, MIAMI, FL 33196-1154
(954) 496-1667
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
10/21/2020
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