Provider Demographics
NPI:1740540608
Name:MIAMI DADE COMMUNITY SERVICES INC
Entity type:Organization
Organization Name:MIAMI DADE COMMUNITY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROIG
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTHCARE MANGMNT
Authorized Official - Phone:305-631-8931
Mailing Address - Street 1:1901 SW 1ST ST FL 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1601
Mailing Address - Country:US
Mailing Address - Phone:305-631-8931
Mailing Address - Fax:305-631-0546
Practice Address - Street 1:1901 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1601
Practice Address - Country:US
Practice Address - Phone:305-631-8931
Practice Address - Fax:305-631-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW16121041C0700X
FL1113AD310901251B00000X, 251S00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111309OtherDEPARTMENT OF CHILDREN AND FAMILIES