Lifeline Community Support, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

LIFELINE COMMUNITY SUPPORT, LLC

Practice address

1666 79TH Street Cswy Ste 603
North Bay Village, FL 33141-4190

Phone

(178) 651-8893

Fax

(786) 254-7303

NPI assigned

Aug 28, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Sergio Alejandro Villatoro, BHCMNPI 1700590643

Title

President

Phone

(786) 518-8931

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sergio Alejandro Villatoro Sr., CBHCMS

  • Case Manager/Care Coordinator
  • North Bay Village, FL
  • NPI 1700590643
  NPD Authorized official

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1619580669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 79TH STREET CSWY STE 603",
            "city": "NORTH BAY VILLAGE",
            "state": "FL",
            "postal_code": "331414190",
            "telephone_number": "786-518-8931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 79TH STREET CSWY STE 603",
            "city": "NORTH BAY VILLAGE",
            "state": "FL",
            "postal_code": "331414190",
            "telephone_number": "178-651-8893",
            "fax_number": "786-254-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE COMMUNITY SUPPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "VILLATORO",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_middle_name": "ALEJANDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-518-8931",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BHCM"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in North Bay Village, FL
• Providers in North Bay Village, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.