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General NPI Number Information
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NPI Number | 1336891167
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Entity Type | Organization
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Legal Business Name | HCP OF CENTRAL FLORIDA, INC.
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Dates
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Enumeration Date | 01/23/2022
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 33 BLUFF LAKE RD
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City | MASCOTTE
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State | FL
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Zip | 34753-9516
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Country | US
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Telephone | 352-557-4112
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Fax | 352-429-1420
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Provider Business Mailing Address
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Address Line | PO BOX 803
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City | MASCOTTE
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State | FL
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Zip | 34753-0803
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Country | US
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Telephone | 352-255-6931
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Fax |
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Authorized Official
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Title or Position | MEDICAID WAIVER PROVIDER
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Name | HEIDI PETERS
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Credential |
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Telephone | 352-255-6931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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