Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Club Community Care LLC

Organization Case Management Agency · NPI 1982200382

Club Community Care LLC is a Case Management Agency in Lake City, Florida. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

164 NW Madison St
Lake City, FL 32055-3904
Phone: (786) 587-9814
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X
Case Management Agency Taxonomy 251B00000X

Record details

NPI number1982200382
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Damary Diaz Hernandez — President · (786) 497-1134
NPI enumeratedDecember 10, 2020
Last updated in NPPESDecember 10, 2020
Certification dateDecember 10, 2020
Mailing address164 Nw Madison St, Lake City, FL 32055-3904

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