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General NPI Number Information
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NPI Number | 1649555665
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOME SOCIETY OF FLORIDA, INC.
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 1208 E WADE ST
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City | TRENTON
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State | FL
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Zip | 32693-2780
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Country | US
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Telephone | 352-463-3110
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Fax |
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Provider Business Mailing Address
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Address Line | 5766 S SEMORAN BLVD
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City | ORLANDO
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State | FL
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Zip | 32822-4818
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Country | US
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Telephone | 321-397-3000
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Fax |
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Authorized Official
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Title or Position | PROVIDER RELATIONS MANAGER
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Name | EILEEN TOSOLINI
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Credential |
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Telephone | 407-375-2565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 100005094
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License Number State | FL
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