Organization
LIFE WELL BEHAVIORAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIANET GONZALEZ (PRESIDENT)
(786) 759-8995
Entity
Organization
Contact information
Practice address
2801 NW 87TH AVE STE 7, DORAL, FL 33172-1604
(786) 717-6881
(786) 717-6355
Mailing address
2801 NW 87TH AVE STE 7, DORAL, FL 33172-1604
(786) 717-6881
(786) 717-6355
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019851500
—
FL
Enumeration date
03/16/2015
Last updated
08/16/2021
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