Provider Demographics
NPI:1023108230
Name:MIAMI HOME & COMMUNITY SUPPORT SERVICES INC.
Entity type:Organization
Organization Name:MIAMI HOME & COMMUNITY SUPPORT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:HHA
Authorized Official - Phone:305-386-9946
Mailing Address - Street 1:7630 SW 137TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3109
Mailing Address - Country:US
Mailing Address - Phone:305-386-9946
Mailing Address - Fax:305-386-9946
Practice Address - Street 1:7630 SW 137TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3109
Practice Address - Country:US
Practice Address - Phone:305-386-9946
Practice Address - Fax:305-386-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL689423296Medicaid
FL689423298Medicaid