Provider Demographics
NPI:1134608102
Name:SELF-CARE COMMUNITY LLC
Entity type:Organization
Organization Name:SELF-CARE COMMUNITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARIADNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-790-7179
Mailing Address - Street 1:8700 W FLAGLER ST STE 340
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2549
Mailing Address - Country:US
Mailing Address - Phone:786-558-8465
Mailing Address - Fax:786-502-2649
Practice Address - Street 1:8700 W FLAGLER ST STE 340
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2549
Practice Address - Country:US
Practice Address - Phone:786-558-8465
Practice Address - Fax:786-502-2649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health