Provider Demographics
NPI:1609374115
Name:SPECIAL NEEDS CARE INC
Entity Type:Organization
Organization Name:SPECIAL NEEDS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LASSUS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:786-445-5607
Mailing Address - Street 1:12970 SW 133RD CT STE A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5806
Mailing Address - Country:US
Mailing Address - Phone:786-445-5607
Mailing Address - Fax:305-603-8909
Practice Address - Street 1:12970 SW 133RD CT STE A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5806
Practice Address - Country:US
Practice Address - Phone:786-445-5607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022076900Medicaid