Organization
INTEGRATED COMMUNITY SUPPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIO RODRIGUEZ (PRESIDENT)
(786) 818-5289
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)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261QM0801X
—
FL
Enumeration date
01/09/2020
Last updated
11/12/2021
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