Provider Demographics
NPI:1003527763
Name:FAMILY COMMUNITY CARE AND BEHAVIORAL SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY COMMUNITY CARE AND BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:MONZON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-266-5803
Mailing Address - Street 1:7791 NW 46TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5476
Mailing Address - Country:US
Mailing Address - Phone:954-394-2447
Mailing Address - Fax:786-364-1461
Practice Address - Street 1:7791 NW 46TH ST STE 101
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5476
Practice Address - Country:US
Practice Address - Phone:954-394-2447
Practice Address - Fax:786-364-1461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health