Provider Demographics
NPI:1336891167
Name:HCP OF CENTRAL FLORIDA, INC.
Entity Type:Organization
Organization Name:HCP OF CENTRAL FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID WAIVER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-255-6931
Mailing Address - Street 1:PO BOX 803
Mailing Address - Street 2:
Mailing Address - City:MASCOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:34753-0803
Mailing Address - Country:US
Mailing Address - Phone:352-255-6931
Mailing Address - Fax:
Practice Address - Street 1:5015 WHISPERING WING LN
Practice Address - Street 2:
Practice Address - City:MASCOTTE
Practice Address - State:FL
Practice Address - Zip Code:34753-8880
Practice Address - Country:US
Practice Address - Phone:352-557-4314
Practice Address - Fax:352-429-1420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-23
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities