Organization
GULF COAST JEWISH FAMILY AND COMMUNITY SERVICES
Active
Other names
GULF COAST COMMUNITY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN JIMENEZ YANDEK (DIRECTOR CREDENTIALING/BILLING)
(727) 430-3291
Entity
Organization
Contact information
Practice address
201 NE 40TH CT, OAKLAND PARK, FL 33334-1311
(727) 450-7269
(727) 479-1248
Mailing address
14041 ICOT BLVD, CLEARWATER, FL 33760-3702
(727) 450-7269
(727) 479-1248
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
8601
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060569703
—
FL
01
—
8601
STATE OF FL - AHCA
FL
Enumeration date
05/21/2007
Last updated
02/18/2022
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