SMA HEALTHCARE INC NPI 1356329163

NPI Information

NPI: 1356329163
Provider Name: SMA HEALTHCARE INC

Former Legal Business Name: ACT CORPORATION

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1220 WILLIS AVE
DAYTONA BEACH, FL
ZIP 32114
Phone: (386) 236-3225
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SMA HEALTHCARE INC is a mental health (including community mental health center) clinic center in Daytona Beach, FL. SMA HEALTHCARE INC NPI is 1356329163. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Act Corporation.

The provider's business location address is:

1220 WILLIS AVE
DAYTONA BEACH, FL
ZIP 32114-810
Phone: (386) 236-3225
Fax: (386) 236-3175

The provider's authorized official is Ivan A Cosimi .
The authorized official title is Ceo/president and has the following contact phone number (386) 236-1811.

The enumeration date for this NPI number is 1/3/2006 and was last updated on 6/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	060311200	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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