Healthcare Provider Details

I. General information

NPI: 1699359547
Provider Name (Legal Business Name): WHEAT COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 LAKE WORTH RD
GREENACRES FL
33463-3209
US

IV. Provider business mailing address

5875 LAKE WORTH RD
GREENACRES FL
33463-3209
US

V. Phone/Fax

Practice location:
  • Phone: 305-682-8700
  • Fax: 305-682-8994
Mailing address:
  • Phone: 305-682-8700
  • Fax: 305-682-8994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. REGINA COOPER
Title or Position: DIRECTOR
Credential:
Phone: 954-661-7227