Organization
COMMUNITY SUPPORTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS CARRALERO (CEO)
(813) 551-8110
Entity
Organization
Contact information
Practice address
9642 SW 72ND ST, MIAMI, FL 33173-3250
(813) 551-8110
Mailing address
9642 SW 72ND ST, MIAMI, FL 33173-3250
(813) 551-8110
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103363700
—
FL
Enumeration date
08/16/2021
Last updated
08/25/2021
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