Organization
LIFELINE COMMUNITY SUPPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SERGIO ALEJANDRO VILLATORO BHCM (PRESIDENT)
(786) 518-8931
Entity
Organization
Contact information
Practice address
1666 79TH STREET CSWY STE 603, NORTH BAY VILLAGE, FL 33141-4190
(178) 651-8893
(786) 254-7303
Mailing address
1666 79TH STREET CSWY STE 603, NORTH BAY VILLAGE, FL 33141-4190
(786) 518-8931
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/18/2021
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