NPIMap

Organization Active NPI

Care Resource Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Wilton Manors, FL
National Provider Identifier
1093717464
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CARE RESOURCE COMMUNITY HEALTH CENTERS, INC
Practice address
871 W Oakland Park Blvd
Wilton Manors, FL 33311
Phone
(954) 567-7141
Fax
(954) 565-5624
NPI assigned
Aug 15, 2005
Last updated
Jan 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steven Santiago, MDNPI 1316080682
Title
Ceo
Phone
(305) 576-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X FL
Federally Qualified Health Center (FQHC) 261QF0400X FL Primary

Addresses

Primary practice location

871 W Oakland Park Blvd
Wilton Manors, FL 33311

Mailing address

3510 Biscayne Blvd
Miami, FL 33137-3859
Phone (305) 576-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040714000096 FL Part B Supplier - Clinic/Group Practice 1658350749 Receives reassigned benefits from 50 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL; Miami Beach, FL; Oakland Park, FL; Wilton Manors, FL
O20100128000057 FL Part A Provider - Federally Qualified Health Center (FQHC) 1658350749 Practice locations: Wilton Manors, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093717464. Details of each certification follow.

Federally qualified health center certification: CCN 101043

Legal name
CARE RESOURCE COMMUNITY HEALTH CENTERS, INC
Doing business as
CARE RESOURCE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 1, 2009
Last certification
Mar 1, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 14, 1983 in FL
Enrollment address
871 W Oakland Park Blvd
Wilton Manors, FL 33311-1731

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Care Resource Community Health Centers Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dan Falcon Individual Corporate Director Mar 1, 2009
Anthony Hernandez Individual Corporate Director Mar 1, 2009
Sonja Smith Individual Corporate Director Mar 1, 2009
Jay Beskin Individual Corporate Director Mar 1, 2009
Dorothy a Holmes Individual Corporate Director Mar 1, 2009
George Castrataro Individual Corporate Director Mar 1, 2009
Russell Corbett Individual Corporate Director Mar 1, 2009
Ana Garcia Individual Corporate Director Mar 1, 2009
Daniel Sera Individual Corporate Director Mar 1, 2009
Steven Santiago Individual Operational/Managerial ControlCeo Oct 1, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Care Resource Community Health Centers, IncMiami, FL, CCN 681010 Federally qualified health center Operational/Managerial Control Jun 15, 2012
Care ResourceMiami Beach, FL, CCN 681118 Federally qualified health center Operational/Managerial Control Jul 1, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1093717464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 BISCAYNE BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373859",
            "telephone_number": "305-576-1234",
            "fax_number": "305-571-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 W OAKLAND PARK BLVD",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "33311",
            "telephone_number": "954-567-7141",
            "fax_number": "954-565-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE RESOURCE COMMUNITY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-576-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

Verify at the official NPI Registry.