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General NPI Number Information
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NPI Number | 1801535497
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Entity Type | Organization
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Legal Business Name | COMMUNITY CASE MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 06/01/2022
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 618 E SOUTH ST STE 500
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City | ORLANDO
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State | FL
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Zip | 32801-2986
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Country | US
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Telephone | 786-693-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 815 NW 57TH AVE STE 400
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City | MIAMI
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State | FL
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Zip | 33126-2042
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Country | US
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Telephone | 786-693-6500
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | IGOR NUNEZ
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Credential |
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Telephone | 786-325-6219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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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 |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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