Organization
SMA HEALTHCARE INC
Active
Parent organization
SMA HEALTHCARE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMA HEALTHCARE INC
Authorized official
MR. IVAN COSIMI (CEO)
(386) 236-1811
Entity
Organization
Contact information
Practice address
301 JUSTICE LN, BUNNELL, FL 32110-4487
(800) 539-4228
Mailing address
150 MAGNOLIA AVE, DAYTONA BEACH, FL 32114-4304
(386) 236-3215
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100348100
—
FL
Enumeration date
08/19/2021
Last updated
08/19/2021
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