Provider Demographics
NPI:1073630182
Name:THE CRISIS CENTER OF TAMPA BAY INC
Entity Type:Organization
Organization Name:THE CRISIS CENTER OF TAMPA BAY INC
Other - Org Name:TRANSCARE MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-969-4999
Mailing Address - Street 1:PO BOX 280059
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33682-0059
Mailing Address - Country:US
Mailing Address - Phone:813-964-1594
Mailing Address - Fax:813-964-1591
Practice Address - Street 1:1 CRISIS CENTER PLZ
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1238
Practice Address - Country:US
Practice Address - Phone:813-964-1594
Practice Address - Fax:813-964-1591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29173416L0300X, 343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL400043900Medicaid
FLA0702Medicare ID - Type Unspecified
FL=========-00OtherBETTER WORKERS COMPENSATI
FL400043900Medicaid
FL591785565002OtherCHAMPUS
FL590012724Medicare ID - Type UnspecifiedRAILROAD MEDICARE
FLX11756Medicare UPIN