Provider Demographics
NPI:1043886104
Name:GOLD COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:GOLD COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUSNAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PENTON DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-580-8357
Mailing Address - Street 1:218 ALMERIA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5904
Mailing Address - Country:US
Mailing Address - Phone:786-580-8357
Mailing Address - Fax:
Practice Address - Street 1:218 ALMERIA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5904
Practice Address - Country:US
Practice Address - Phone:786-580-8357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health