| Mediterranean Mental Health Center, Inc. | |
|
30 Acoma Blvd S 101-103 Lake Havasu City AZ 86403-5957 | |
| (928) 680-0604 | |
| (928) 680-0605 |
| Full Name | Mediterranean Mental Health Center, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 30 Acoma Blvd S, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Vasilios W. Kaperonis (PRESIDENT) |
| Authorized Official Contact | 9286800604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mediterranean Mental Health Center, Inc. 30 Acoma Blvd S 101-103 Lake Havasu City AZ 86403-5957 Ph: (928) 680-0604 | Mediterranean Mental Health Center, Inc. 30 Acoma Blvd S 101-103 Lake Havasu City AZ 86403-5957 Ph: (928) 680-0604 |
| NPI Number | 1619903986 |
|---|---|
| Provider Enumeration Date | 06/25/2006 |
| Last Update Date | 10/22/2012 |
| Medicare PECOS PAC ID | 4587814876 |
|---|---|
| Medicare Enrollment ID | O20121023000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619903986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 20732 (Arizona) | Primary |
| Provider Name | Vasilios W Kaperonis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124214093 PECOS PAC ID: 4385664713 Enrollment ID: I20051130000828 |
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