Provider Demographics
NPI:1619591369
Name:VDZ LEADING COMMUNITY SERVICES, LLC
Entity Type:Organization
Organization Name:VDZ LEADING COMMUNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:R
Authorized Official - Last Name:REYES CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-674-8558
Mailing Address - Street 1:801 MONTEREY ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2537
Mailing Address - Country:US
Mailing Address - Phone:727-674-8558
Mailing Address - Fax:
Practice Address - Street 1:801 MONTEREY ST STE 202
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2537
Practice Address - Country:US
Practice Address - Phone:727-674-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management