Countyline Support Services Corp

LBN: Countyline Support Services Corp
Countyline Support Services Corp is an health care organization with primary practice located at 2114 N Flamingo Rd # 166 , Pembroke Pines FL 33028-3501. The organization recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as the primary health care specialty. Countyline Support Services Corp can be contacted via phone (954) 632-9891, or through Munford, Mauva Angela via phone (954) 632-9891.

Contact Information

Primary practice address
2114 N Flamingo Rd # 166 Pembroke Pines FL 33028-3501
Phone: (954) 632-9891
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Munford, Mauva Angela
Phone: (954) 632-9891

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X

Profile Details

NPI number 1265911531
LBN Legal business name Countyline Support Services Corp
DBA Doing business as
Authorized official Munford, Mauva Angela
Entity Organization
Organization subpart 1 No
Enumeration date Aug 8th, 2018
Last updated Aug 8th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265911531 NPPES
Florida MEDICAID 100207900

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