Organization
MGM CASE MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAIMARY RIVERO BCBA (AUTHORIZED OFFICIAL)
(305) 827-2822
Entity
Organization
Contact information
Practice address
8040 NW 155TH ST # 320, MIAMI LAKES, FL 33016-5880
(305) 827-2822
Mailing address
14411 COMMERCE WAY, 320, MIAMI LAKES, FL 33016-1596
(786) 597-3928
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11622729
BACB
FL
Enumeration date
05/26/2011
Last updated
10/16/2020
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