Provider Demographics
NPI:1396910071
Name:IMARA COMMUNITY SERVICES
Entity type:Organization
Organization Name:IMARA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-688-0870
Mailing Address - Street 1:2240 PALM BEACH LAKES BLVD
Mailing Address - Street 2:SUITE 400E
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3410
Mailing Address - Country:US
Mailing Address - Phone:561-688-0870
Mailing Address - Fax:561-537-7161
Practice Address - Street 1:2240 PALM BEACH LAKES BLVD
Practice Address - Street 2:SUITE 400E
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3410
Practice Address - Country:US
Practice Address - Phone:561-688-0870
Practice Address - Fax:561-537-7161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9206737101YA0400X
FLRN1525422101YM0800X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty