Healthcare Provider Details

I. General information

NPI: 1376884841
Provider Name (Legal Business Name): COMMUNITY RIGHTFUL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2013
Last Update Date: 09/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9526 NE 2ND AVE #203 C& D
MIAMI SHORES FL
33138-2750
US

IV. Provider business mailing address

6818 SW 9TH ST
PEMBROKE PINES FL
33023-1629
US

V. Phone/Fax

Practice location:
  • Phone: 943-815-1192
  • Fax:
Mailing address:
  • Phone: 954-815-1192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSELINE LOUISXVI
Title or Position: CEO
Credential:
Phone: 954-815-1192