Provider Demographics
NPI:1790988855
Name:JESSIE TRICE COMMUNITY HEALTH SYSTEM INC
Entity Type:Organization
Organization Name:JESSIE TRICE COMMUNITY HEALTH SYSTEM INC
Other - Org Name:ECONOMIC OPPORTUNITY FAMILY HEALTH CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-637-6498
Mailing Address - Street 1:2985 NW 54TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-2827
Mailing Address - Country:US
Mailing Address - Phone:305-637-6498
Mailing Address - Fax:305-638-3473
Practice Address - Street 1:2985 NW 54TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-2827
Practice Address - Country:US
Practice Address - Phone:305-637-6498
Practice Address - Fax:305-638-3473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty