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General NPI Number Information
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NPI Number | 1194073304
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Entity Type | Organization
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Legal Business Name | CONSUMER SUPPORT NETWORK, LTD. CO.
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Dates
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Enumeration Date | 08/17/2012
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Last Update Date | 08/17/2012
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Provider Practice Location Address
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Address Line | 1175 NE 125TH ST STE 413
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5015
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Country | US
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Telephone | 305-981-0300
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Fax | 305-981-0500
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Provider Business Mailing Address
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Address Line | 2449 SW GAMBERI ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-2711
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Country | US
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Telephone | 305-981-0300
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Fax | 305-981-0500
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. MARCELLE JEAN FRANCOIS
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Credential | M.ED
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Telephone | 305-981-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | FL
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