Provider Demographics
NPI:1225282924
Name:BOARD OF COUNTY COMMISSIONERS CITRUS COUNTY
Entity Type:Organization
Organization Name:BOARD OF COUNTY COMMISSIONERS CITRUS COUNTY
Other - Org Name:CITRUS COUNTY, A POLITICAL SUBDIVISION OF THE STATE OF FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-341-6560
Mailing Address - Street 1:2804 W MARC KNIGHTON CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-6300
Mailing Address - Country:US
Mailing Address - Phone:352-527-5900
Mailing Address - Fax:352-527-5908
Practice Address - Street 1:2804 W MARC KNIGHTON CT
Practice Address - Street 2:SUITE B
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-6300
Practice Address - Country:US
Practice Address - Phone:352-527-5900
Practice Address - Fax:352-527-5908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0509AD0548251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0248801 01Medicaid
FL0248801 00Medicaid
FL0248801 68Medicaid
FL0842150 98Medicaid
FL0842150 96Medicaid