Provider Demographics
NPI:1376027193
Name:CHILDREN'S HOME SOCIETY OF FLORIDA
Entity Type:Organization
Organization Name:CHILDREN'S HOME SOCIETY OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOSOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-397-5251
Mailing Address - Street 1:5766 S SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-4818
Mailing Address - Country:US
Mailing Address - Phone:321-397-3000
Mailing Address - Fax:
Practice Address - Street 1:1010 E ROSE ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-2016
Practice Address - Country:US
Practice Address - Phone:321-397-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOME SOCIETY OF FLORIDA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-18
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102213700Medicaid