Provider Demographics
NPI:1649900853
Name:FLORIDA RECOVERY SCHOOLS OF TAMPA BAY, INC.
Entity type:Organization
Organization Name:FLORIDA RECOVERY SCHOOLS OF TAMPA BAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-288-7652
Mailing Address - Street 1:PO BOX 4009
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34692-1009
Mailing Address - Country:US
Mailing Address - Phone:727-288-7652
Mailing Address - Fax:
Practice Address - Street 1:6825 TROUBLE CREEK RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-5560
Practice Address - Country:US
Practice Address - Phone:727-288-7652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA RECOVERY SCHOOLS OF TAMPA BAY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)