Provider Demographics
NPI:1437758364
Name:COMMUNITY CHOICE HEALTH NETWORK CORP
Entity Type:Organization
Organization Name:COMMUNITY CHOICE HEALTH NETWORK CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-PRADA
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:305-557-2328
Mailing Address - Street 1:5985 W 25TH CT STE A108
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4462
Mailing Address - Country:US
Mailing Address - Phone:305-557-2328
Mailing Address - Fax:305-846-9238
Practice Address - Street 1:5985 W 25TH CT STE A108
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4462
Practice Address - Country:US
Practice Address - Phone:305-557-2328
Practice Address - Fax:305-846-9238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)