Organization
MCCLUSKY ENTERPRISES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JAMES MCCLUSKY BCBA (BEHAVIOR ANALYST)
(813) 653-4072
Entity
Organization
Contact information
Practice address
110B LITHIA PINECREST RD STE B, BRANDON, FL 33511-5306
(813) 653-4072
(813) 661-4456
Mailing address
110-B LITHIA PINECREST ROAD SUITE B, BRANDON, FL 33511-5300
(813) 653-4072
(813) 661-4456
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
671327196
—
FL
Enumeration date
07/28/2008
Last updated
07/28/2008
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