| Gulf Coast Community Care | |
|
201 Ne 40th Ct Oakland Park FL 33334-1311 | |
| (727) 450-7269 | |
| (727) 479-1248 |
| Full Name | Gulf Coast Community Care |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 201 Ne 40th Ct, Oakland Park, Florida |
| Authorized Official Name and Position | Carolyn Jimenez Yandek (DIRECTOR CREDENTIALING/BILLING) |
| Authorized Official Contact | 7274303291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Community Care 14041 Icot Blvd Clearwater FL 33760-3702 Ph: (727) 450-7269 | Gulf Coast Community Care 201 Ne 40th Ct Oakland Park FL 33334-1311 Ph: (727) 450-7269 |
| NPI Number | 1851500409 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 02/18/2022 |
| Certification Date | 02/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851500409 | NPI | - | NPPES |
| 060569703 | Medicaid | FL | |
| 8601 | Other | FL | STATE OF FL - AHCA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | 8601 (Florida) | Secondary |
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