Provider Demographics
NPI:1851724199
Name:CSI PRIVATE DUTY SERVICES, INC
Entity Type:Organization
Organization Name:CSI PRIVATE DUTY SERVICES, INC
Other - Org Name:FRIENDS ASSISTING SENIORS AND FAMILIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS DEVELOPMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEST RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-821-1262
Mailing Address - Street 1:10451 NW 117TH AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1116
Mailing Address - Country:US
Mailing Address - Phone:305-889-3049
Mailing Address - Fax:305-884-7788
Practice Address - Street 1:1116 PELICAN BAY DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32119-1381
Practice Address - Country:US
Practice Address - Phone:386-761-7351
Practice Address - Fax:386-761-9923
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREGIVER SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-09
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL679650800Medicaid
FL679119109Medicaid
FL679119106Medicaid