Healthcare Provider Details

I. General information

NPI: 1013434679
Provider Name (Legal Business Name): COMMUNITY ALLIANCE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20540 NE 15TH CT
MIAMI FL
33179-2130
US

IV. Provider business mailing address

109 SCOTLAND HILL RD
CHESTNUT RIDGE NY
10977-5968
US

V. Phone/Fax

Practice location:
  • Phone: 786-290-2517
  • Fax:
Mailing address:
  • Phone: 201-403-3145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: JULIETTE RENE
Title or Position: ASSOCIATE DIRECTOR
Credential:
Phone: 201-403-3145