Provider Demographics
NPI:1770235541
Name:CARING CONNECTION OF SOUTH FL, INC
Entity Type:Organization
Organization Name:CARING CONNECTION OF SOUTH FL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SELKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-358-7102
Mailing Address - Street 1:9 REDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-9352
Mailing Address - Country:US
Mailing Address - Phone:561-358-7102
Mailing Address - Fax:
Practice Address - Street 1:9 REDWOOD CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-9352
Practice Address - Country:US
Practice Address - Phone:561-358-7102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102712400Medicaid
FL677633796Medicaid