Provider Demographics
NPI:1427660828
Name:TRUST COMMUNITY CENTER LLC
Entity type:Organization
Organization Name:TRUST COMMUNITY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PUIG
Authorized Official - Suffix:
Authorized Official - Credentials:CBHCM
Authorized Official - Phone:954-807-8956
Mailing Address - Street 1:1500 W CYPRESS CREEK RD STE 420
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1874
Mailing Address - Country:US
Mailing Address - Phone:954-807-8956
Mailing Address - Fax:954-807-8957
Practice Address - Street 1:1500 W CYPRESS CREEK RD STE 420
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1874
Practice Address - Country:US
Practice Address - Phone:954-807-8956
Practice Address - Fax:954-807-8957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management