# JOHN BIRD COMMUNITY SUPPORTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184925752
- **Authorized official:** MS. LINDA IERENE FLORES (VICE PRESIDENT)
- **Authorized official phone:** (941) 685-9684

## Contact information

- **Practice address:** 4788 253RD ST E, MYAKKA CITY, FL 34251-8956
- **Practice address phone:** (941) 920-1533
- **Practice address fax:** (941) 362-9798
- **Mailing address:** 4788 253RD ST E, MYAKKA CITY, FL 34251-8956
- **Mailing address phone:** (941) 920-1533
- **Mailing address fax:** (941) 362-9798

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 000992300 | FL | Yes |
| 251B00000X | Case Management Agency | 000992301 | FL | — |

## Other

- **Enumeration date:** 11/12/2010
- **Last updated:** 11/12/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000992300 | MEDICAID WAIVER | FL |
| 01 | — | 000992301 | MEDICAID SMALL WAIVER | FL |