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Organization
INTEGRATED COMMUNITY SUPPORT, LLC
Active
Organization
INTEGRATED COMMUNITY SUPPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAX CARRILLO (PRESIDENT)
(305) 790-5075
Entity
Organization
Contact information
Practice address
13643 SW 26TH ST, MIAMI, FL 33175-6378
(305) 400-8281
(305) 400-8513
Mailing address
13643 SW 26TH ST, MIAMI, FL 33175-6378
(305) 400-8281
(305) 400-8513
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/09/2020
Last updated
10/12/2026
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