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Organization
HILLENDALE CARES LLC
Active
Organization
HILLENDALE CARES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT M ROTH (ADMINISTRATOR)
(352) 345-4698
Entity
Organization
Contact information
Practice address
27357 FRAMPTON AVE, BROOKSVILLE, FL 34602-7306
(352) 345-4698
Mailing address
27357 FRAMPTON AVE, BROOKSVILLE, FL 34602-7306
(352) 345-4698
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101372900
—
FL
05
—
109683100
—
FL
Enumeration date
07/30/2021
Last updated
07/30/2021
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