| Community Supporting Llc | |
|
9642 Sw 72nd St Miami FL 33173-3250 | |
| (813) 551-8110 | |
| Not Available |
| Full Name | Community Supporting Llc |
|---|---|
| Speciality | Case Management |
| Location | 9642 Sw 72nd St, Miami, Florida |
| Authorized Official Name and Position | Luis Carralero (CEO) |
| Authorized Official Contact | 8135518110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Supporting Llc 9642 Sw 72nd St Miami FL 33173-3250 Ph: (813) 551-8110 | Community Supporting Llc 9642 Sw 72nd St Miami FL 33173-3250 Ph: (813) 551-8110 |
| NPI Number | 1841965316 |
|---|---|
| Provider Enumeration Date | 08/16/2021 |
| Last Update Date | 08/25/2021 |
| Certification Date | 08/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841965316 | NPI | - | NPPES |
| 103363700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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