Provider Demographics
NPI:1144830902
Name:BL COMMUNITY SERVICES CORP.
Entity type:Organization
Organization Name:BL COMMUNITY SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-748-8276
Mailing Address - Street 1:2719 HOLLYWOOD BLVD # 14
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4821
Mailing Address - Country:US
Mailing Address - Phone:954-526-1718
Mailing Address - Fax:
Practice Address - Street 1:2719 HOLLYWOOD BLVD # 14
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4821
Practice Address - Country:US
Practice Address - Phone:954-526-1718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management