Provider Demographics
NPI:1790725406
Name:YOUTH AND FAMILY CENTERED SERVICES OF FL, INC.
Entity Type:Organization
Organization Name:YOUTH AND FAMILY CENTERED SERVICES OF FL, INC.
Other - Org Name:TAMPA BAY ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-677-6700
Mailing Address - Street 1:12012 BOYETTE ROAD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5631
Mailing Address - Country:US
Mailing Address - Phone:813-677-6700
Mailing Address - Fax:813-671-3145
Practice Address - Street 1:12012 BOYETTE ROAD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5631
Practice Address - Country:US
Practice Address - Phone:813-677-6700
Practice Address - Fax:813-671-3145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0605-39323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility