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General NPI Number Information
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NPI Number | 1396311163
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Entity Type | Organization
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Legal Business Name | P&M COMMUNITY SUPPORT,LLC.
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 10887 NW 17TH ST UNIT 109
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City | MIAMI
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State | FL
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Zip | 33172-2044
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Country | US
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Telephone | 786-925-5698
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Fax |
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Provider Business Mailing Address
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Address Line | 10887 NW 17TH ST UNIT 109
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City | MIAMI
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State | FL
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Zip | 33172-2044
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Country | US
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Telephone | 786-925-5698
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER SUPERVISOR
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Name | JOHANN MOREJON
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Credential | CBHCMS
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Telephone | 786-925-5698
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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 |
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