Organization
JOHN BIRD COMMUNITY SUPPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA IERENE FLORES (VICE PRESIDENT)
(941) 685-9684
Entity
Organization
Contact information
Practice address
4788 253RD ST E, MYAKKA CITY, FL 34251-8956
(941) 920-1533
(941) 362-9798
Mailing address
4788 253RD ST E, MYAKKA CITY, FL 34251-8956
(941) 920-1533
(941) 362-9798
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
000992300
FL
251B00000X
Case Management Agency
000992301
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000992300
MEDICAID WAIVER
FL
01
—
000992301
MEDICAID SMALL WAIVER
FL
Enumeration date
11/12/2010
Last updated
11/12/2010
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