Provider Demographics
NPI:1982054441
Name:SANTANA CARE SERV CORP
Entity Type:Organization
Organization Name:SANTANA CARE SERV CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:NATACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-776-8183
Mailing Address - Street 1:17801 NW 12TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4184
Mailing Address - Country:US
Mailing Address - Phone:305-766-8183
Mailing Address - Fax:
Practice Address - Street 1:665 W 68TH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4184
Practice Address - Country:US
Practice Address - Phone:786-773-3393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health