Provider Demographics
NPI:1679578322
Name:CHILDREN'S HOME SOCIETY OF FLORIDA
Entity Type:Organization
Organization Name:CHILDREN'S HOME SOCIETY OF FLORIDA
Other - Org Name:CHILDRENS HOME SOCIETY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIR. BEHAVIORAL HEALTH BUSINESS OPS
Authorized Official - Prefix:
Authorized Official - First Name:LIMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA, CPC
Authorized Official - Phone:407-663-6764
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:312-397-3000
Mailing Address - Fax:321-397-3024
Practice Address - Street 1:5768 S SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-4818
Practice Address - Country:US
Practice Address - Phone:312-397-3000
Practice Address - Fax:321-397-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-19
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070680900Medicaid
FL114972900Medicaid