Provider Demographics
NPI:1902436363
Name:JACKSON HEALTH COMMUNITY CENTER CORP
Entity Type:Organization
Organization Name:JACKSON HEALTH COMMUNITY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ALINA
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-656-3266
Mailing Address - Street 1:351 NW 42ND AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5689
Mailing Address - Country:US
Mailing Address - Phone:786-536-5168
Mailing Address - Fax:786-536-5188
Practice Address - Street 1:351 NW 42ND AVE STE 408
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5689
Practice Address - Country:US
Practice Address - Phone:786-536-5168
Practice Address - Fax:786-536-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty