Provider Demographics
NPI:1922603323
Name:THE VILLAGE COMMUNITY SUPPORT SERVICES
Entity Type:Organization
Organization Name:THE VILLAGE COMMUNITY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:786-899-1757
Mailing Address - Street 1:15700 NW 2ND AVE APT 213
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6767
Mailing Address - Country:US
Mailing Address - Phone:305-763-7022
Mailing Address - Fax:
Practice Address - Street 1:15700 NW 2ND AVE APT 213
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6767
Practice Address - Country:US
Practice Address - Phone:305-763-7022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health