Organization
HOMESTEAD BEHAVIORAL CLINIC, INC.
Active
Parent organization
HOMESTEAD BEHAVIORAL CLINIC, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOMESTEAD BEHAVIORAL CLINIC, INC.
Authorized official
AIDELYN LOPEZ (PRESIDENT)
(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
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260257100
—
FL
Enumeration date
06/29/2021
Last updated
06/29/2021
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