Provider Demographics
NPI:1164584082
Name:CENTRAL FLORIDA COMMUNITIES INC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA COMMUNITIES INC
Other - Org Name:HOWELL BRANCH COURT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-DSI MANAGEMENT (MGMT. CO)
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-645-3211
Mailing Address - Street 1:1890 STATE ROAD 436
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2285
Mailing Address - Country:US
Mailing Address - Phone:407-645-3211
Mailing Address - Fax:407-628-2853
Practice Address - Street 1:3664 HOWELL BRANCH COURT
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1701
Practice Address - Country:US
Practice Address - Phone:407-671-1115
Practice Address - Fax:407-671-6043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4035096315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0285676Medicaid
FL4452860003Medicare NSC