Provider Demographics
NPI:1760927123
Name:ADVANCE COMMUNITY SERVICES CORP
Entity Type:Organization
Organization Name:ADVANCE COMMUNITY SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-224-9376
Mailing Address - Street 1:18901 SW 106TH AVE
Mailing Address - Street 2:SUITE # 229
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157
Mailing Address - Country:US
Mailing Address - Phone:305-224-9376
Mailing Address - Fax:786-581-5534
Practice Address - Street 1:18901 SW 106TH AVE
Practice Address - Street 2:SUITE # 229
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157
Practice Address - Country:US
Practice Address - Phone:305-224-9376
Practice Address - Fax:786-581-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health