Provider Demographics
NPI:1609380534
Name:ADVANCED CARE AND SUPPORT SERVICES LLC.
Entity Type:Organization
Organization Name:ADVANCED CARE AND SUPPORT SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:WOLDY
Authorized Official - Last Name:FILS-AIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-238-1523
Mailing Address - Street 1:11601 BISCAYNE BLVD
Mailing Address - Street 2:101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3151
Mailing Address - Country:US
Mailing Address - Phone:786-238-1523
Mailing Address - Fax:
Practice Address - Street 1:11601 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3151
Practice Address - Country:US
Practice Address - Phone:786-238-1523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities