Basic Information
| Provider Information | |||||||||
| NPI: | 1013984079 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY LINKS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10117 SE US HIGHWAY 441 | ||||||||
| Address2: | P. O. BOX 3031 | ||||||||
| City: | BELLEVIEW | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344202809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523472700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10117 SE US HIGHWAY 441 | ||||||||
| Address2: | |||||||||
| City: | BELLEVIEW | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344202809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523472700 | ||||||||
| FaxNumber: | 3523472726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 12/27/2010 | ||||||||
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| AuthorizedOfficialLastName: | SPOTTS | ||||||||
| AuthorizedOfficialFirstName: | HILDA | ||||||||
| AuthorizedOfficialMiddleName: | MELERO | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/ CEO | ||||||||
| AuthorizedOfficialTelephone: | 3523472700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW 6499 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 683583098 | 01 | FAMILY AND COMMUNITY BASED WAIVER | OTHER | 683583096 | 01 | FL | CHBS MEDICAID WAIVER | OTHER |