Healthcare Provider Details

I. General information

NPI: 1801728753
Provider Name (Legal Business Name): 1330 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 DOUGLAS AVE
DUNEDIN FL
34698-2604
US

IV. Provider business mailing address

2029 DOUGLAS AVE
DUNEDIN FL
34698-2604
US

V. Phone/Fax

Practice location:
  • Phone: 813-380-4990
  • Fax: 813-200-8088
Mailing address:
  • Phone: 813-380-4990
  • Fax: 813-200-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CASH
Title or Position: MANAGING PARTNER
Credential:
Phone: 813-380-4990