Organization
CUSTOMIZED CARE MANAGEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NERLYN JESTINE (CEO)
(561) 328-7527
Entity
Organization
Contact information
Practice address
4121 PARKER AVE, WEST PALM BEACH, FL 33405-2507
(561) 460-2464
Mailing address
4119 PARKER AVE, WEST PALM BEACH, FL 33405-2507
(561) 328-7527
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
363L00000X
Nurse Practitioner
Primary
ARNP9227682
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017276500
—
FL
Enumeration date
02/24/2016
Last updated
06/12/2021
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