1477809853 NPI number — CARING AND SHARING CENTER FOR INDEPENDENT LIVING, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477809853 NPI number — CARING AND SHARING CENTER FOR INDEPENDENT LIVING, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARING AND SHARING CENTER FOR INDEPENDENT LIVING, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DISABILITY ACHIEVEMENT CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477809853
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12552 BELCHER RD S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LARGO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33773-3014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-539-7550
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12552 BELCHER RD S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33773-3014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-539-7550
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
727-539-7550

Provider Taxonomy Codes

  • Taxonomy code: 171WH0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002845000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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