Healthcare Provider Details

I. General information

NPI: 1215338751
Provider Name (Legal Business Name): COMMUNITY AGING & RETIREMENT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 WALLER ST
PLANT CITY FL
33563-6407
US

IV. Provider business mailing address

12417 CLOCK TOWER PKWY
HUDSON FL
34667-2411
US

V. Phone/Fax

Practice location:
  • Phone: 727-862-9291
  • Fax:
Mailing address:
  • Phone: 727-862-9291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number370
License Number StateFL

VIII. Authorized Official

Name: WILLIAM AYCRIGG
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 727-862-9291