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Organization

PROGRESSIVE MENTAL HEALTH CLINIC CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMPARO NIEBLA (PRESIDENT)
(305) 465-9379
Entity
Organization

Contact information

Practice address
12595 SW 137TH AVE STE 203, MIAMI, FL 33186-4221
(305) 465-9379
Mailing address
12595 SW 137TH AVE STE 203, MIAMI, FL 33186-4221
(305) 465-9379

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM1300X
Multi-Specialty Clinic/Center

Other

Enumeration date
01/06/2021
Last updated
01/06/2021
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