Healthcare Provider Details

I. General information

NPI: 1902995681
Provider Name (Legal Business Name): CITRUS COUNTY ASSOCIATION FOR RETARDED CITIZENS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 HEIGHTS AVE
INVERNESS FL
34452-4571
US

IV. Provider business mailing address

130 HEIGHTS AVE
INVERNESS FL
34452-4571
US

V. Phone/Fax

Practice location:
  • Phone: 352-341-4633
  • Fax: 352-341-4656
Mailing address:
  • Phone: 352-341-4633
  • Fax: 352-341-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: HEATHER SMITH
Title or Position: ACCOUNTANT
Credential:
Phone: 352-795-5541