Provider Demographics
NPI:1407226830
Name:ADVANCED SUPPORT COORDINATION SERVICES, INC.
Entity Type:Organization
Organization Name:ADVANCED SUPPORT COORDINATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-351-6133
Mailing Address - Street 1:11117 W OKEECHOBEE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4200
Mailing Address - Country:US
Mailing Address - Phone:305-351-6133
Mailing Address - Fax:786-703-1299
Practice Address - Street 1:11117 W OKEECHOBEE RD STE 115
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4200
Practice Address - Country:US
Practice Address - Phone:305-351-6133
Practice Address - Fax:786-703-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty