MEDICARE: CARE IN MIND COMMUNITY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1245715119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE IN MIND COMMUNITY SERVICES INC

Provider Business Mailing Address
First Line	:	550 FAIRWAY DR STE 105B
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-1875
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14680 SW 8TH ST STE 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-3138
Country	:	US
Telephone Number	:	786-953-8246
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NELLY E MOLA
Credential	:	CBHCM
Telephone Number	:	786-877-1350

Provider Enumeration Date	:	09/26/2018
Last Update Date	:	04/24/2020

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