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General NPI Number Information
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NPI Number | 1427660828
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Entity Type | Organization
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Legal Business Name | TRUST COMMUNITY CENTER LLC
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 1500 W CYPRESS CREEK RD STE 420
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1874
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Country | US
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Telephone | 954-807-8956
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Fax | 954-807-8957
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Provider Business Mailing Address
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Address Line | 1500 W CYPRESS CREEK RD STE 420
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1874
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Country | US
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Telephone | 954-807-8956
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Fax | 954-807-8957
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Authorized Official
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Title or Position | DIRECTOR
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Name | CARLOS PUIG
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Credential | CBHCM
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Telephone | 954-807-8956
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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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