Provider Demographics
NPI:1053498568
Name:THE CENTER FOR INDEPENDENCE INC
Entity type:Organization
Organization Name:THE CENTER FOR INDEPENDENCE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EMILE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-861-5600
Mailing Address - Street 1:13910 FIVAY RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667
Mailing Address - Country:US
Mailing Address - Phone:727-861-5600
Mailing Address - Fax:727-861-5605
Practice Address - Street 1:15750 LITTLE RANCH RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34610
Practice Address - Country:US
Practice Address - Phone:727-861-5600
Practice Address - Fax:727-861-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-05-10
Deactivation Date:2010-12-20
Deactivation Code:
Reactivation Date:2011-05-10
Provider Licenses
StateLicense IDTaxonomies
FLAL10730310400000X
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142553600Medicaid
FL024021496Medicaid