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CLUB COMMUNITY CARE LLC
NPI 1982200382
Community/Behavioral Health in Lake City, FL

Active since December 10, 2020
164 NW MADISON ST, LAKE CITY, FL 32055(786) 587-9814 Get Directions Write a Review

NPPES record last updated: December 10, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Club Community Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLUB COMMUNITY CARE LLC (NPI 1982200382) is a healthcare organization registered as a community/behavioral health in Lake City, Florida and active in the NPI registry since December 2020. The organization lists Damary Diaz Hernandez, President, as its authorized official.

NPPES Registry Identity

NPI1982200382
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameCLUB COMMUNITY CARE LLC
Location Address164 NW MADISON STLake City, FL 32055-3904
Mailing Address164 Nw Madison StLake City, FL 32055-3904 · (786) 587-9814
Phone(786) 587-9814
Organization SubpartNo
Authorized OfficialDamary Diaz HernandezPresident · (786) 497-1134
Enumeration DateDecember 10, 2020
NPPES CertifiedDecember 10, 2020
✔ NPI 1982200382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedCase ManagementTaxonomy 251B00000X
164 NW MADISON ST, Lake City, FL 32055
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRANDLYNN NELSON M.S. CCC-SLP
Speech-Language Pathologist
164 NW MADISON ST
LAKE CITY, FL 32055
Columbia County (386) 758-1811
LAUREN HAGLER
Speech-Language Pathologist
164 NW MADISON ST
LAKE CITY, FL 32055
Columbia County (386) 758-1811
MS. DANIELLE SMITH OTR/L
Occupational Therapist
164 NW MADISON ST
LAKE CITY, FL 32055
Columbia County (386) 758-1811

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Club Community Care LLC's NPI number?

The NPI number for Club Community Care LLC is 1982200382. It was assigned to this organization in the NPPES registry on December 10, 2020.

Where is Club Community Care LLC located?

Club Community Care LLC is located at 164 NW Madison St, Lake City, FL 32055. The listed phone number is (786) 587-9814.

What is Club Community Care LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Club Community Care LLC was last updated on December 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.