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General NPI Number Information
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NPI Number | 1912090713
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH OF SOUTH DADE INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8820 SOUTH WEST 181 STREET 10300 SOUTH WEST 216 STREET
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 305-254-4968
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Fax |
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Provider Business Mailing Address
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Address Line | 8820 SOUTH WEST 191 STREET
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 305-910-4779
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Fax |
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Authorized Official
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Title or Position | TARGET CASE MANAGER
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Name | MRS. KATHY L GOLDMAN
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Credential | BA
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Telephone | 305-254-4969
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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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