Provider Demographics
NPI:1205437332
Name:FAMILY TRUST COMMUNITY SERVICE LLC
Entity type:Organization
Organization Name:FAMILY TRUST COMMUNITY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAILEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-479-2633
Mailing Address - Street 1:15602 SW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2802
Mailing Address - Country:US
Mailing Address - Phone:786-222-2342
Mailing Address - Fax:
Practice Address - Street 1:15260 SW 280TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8185
Practice Address - Country:US
Practice Address - Phone:786-222-2342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management