Organization
COMMUNITY AGING & RETIREMENT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM AYCRIGG (CHIEF EXECUTIVE OFFICER)
(727) 862-9291
Entity
Organization
Contact information
Practice address
3940 CANOGA PARK DR, BRANDON, FL 33511
(813) 330-7964
Mailing address
12417 CLOCK TOWER PKWY, HUDSON, FL 34667-2411
(727) 862-9291
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
9288
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
APPLYING FOR MEDICAID NUMBER
—
Enumeration date
02/16/2015
Last updated
02/16/2015
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