MEDICARE: RESCARE FLORIDA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316111867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESCARE FLORIDA, INC.

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-5186
Country	:	US
Telephone Number	:	800-866-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	2683 JENKS AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4351
Country	:	US
Telephone Number	:	850-872-9044
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT MANAGER
Name	:	ANGIE MATTINGLY
Credential	:
Telephone Number	:	502-630-7425

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	03/05/2020

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