Provider Demographics
NPI:1285993758
Name:COMMUNITY SERVICES OF MIAMI, INC.
Entity type:Organization
Organization Name:COMMUNITY SERVICES OF MIAMI, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVIERA CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-930-2313
Mailing Address - Street 1:6731 SW 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2380
Mailing Address - Country:US
Mailing Address - Phone:786-535-4126
Mailing Address - Fax:786-615-3721
Practice Address - Street 1:6731 SW 135TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2380
Practice Address - Country:US
Practice Address - Phone:786-535-4126
Practice Address - Fax:786-615-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9581310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL140518700Medicaid