Healthcare Provider Details
I. General information
NPI: 1053498568
Provider Name (Legal Business Name): THE CENTER FOR INDEPENDENCE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date: 12/20/2010
Reactivation Date: 05/10/2011
III. Provider practice location address
15750 LITTLE RANCH RD
SPRING HILL FL
34610
US
IV. Provider business mailing address
13910 FIVAY RD SUITE 8
HUDSON FL
34667
US
V. Phone/Fax
- Phone: 727-861-5600
- Fax: 727-861-5605
- Phone: 727-861-5600
- Fax: 727-861-5605
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | AL10730 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
EMILE
LAURINO
Title or Position: CEO
Credential:
Phone: 727-861-5600