Healthcare Provider Details
I. General information
NPI: 1336892769
Provider Name (Legal Business Name): ADULT CARE HOUSING, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2022
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5030 78TH AVE N STE 8
PINELLAS PARK FL
33781-2406
US
IV. Provider business mailing address
5700 92ND AVE N
PINELLAS PARK FL
33782-5010
US
V. Phone/Fax
- Phone: 727-418-6264
- Fax: 727-205-3780
- Phone: 727-418-6264
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
TOLINI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 727-418-6264