Provider Demographics
NPI:1578789921
Name:COMMUNITY AGING & RETIREMENT SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY AGING & RETIREMENT SERVICES, INC.
Other - Org Name:CARES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEMITH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:727-862-9291
Mailing Address - Street 1:12417 CLOCK TOWER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-2411
Mailing Address - Country:US
Mailing Address - Phone:727-862-9291
Mailing Address - Fax:727-862-6013
Practice Address - Street 1:12417 CLOCK TOWER PARKWAY
Practice Address - Street 2:SUITE 5
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2411
Practice Address - Country:US
Practice Address - Phone:727-862-9291
Practice Address - Fax:727-862-6013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20255096251E00000X
251E00000X, 261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL099897400Medicaid
FL099897468Medicaid
FL099897401Medicaid
FL113955700Medicaid
FL099897401Medicaid