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General NPI Number Information
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NPI Number | 1679802722
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Entity Type | Organization
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Legal Business Name | COMMUNITY ACCESS SERVICE
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Dates
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Enumeration Date | 12/21/2009
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 2141 NW 63RD AVE
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City | SUNRISE
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State | FL
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Zip | 33313-2915
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Country | US
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Telephone | 954-234-2364
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Fax | 954-234-2595
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Provider Business Mailing Address
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Address Line | 3810 INVERRARY BLVD SUITE 408
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City | LAUDERHILL
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State | FL
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Zip | 33319-4356
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Country | US
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Telephone | 954-234-2364
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Fax | 954-234-2595
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. NEA DUNCAN RICHARDSON
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Credential |
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Telephone | 954-234-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 12115
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License Number State | FL
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