Organization
HUMAN DEVELOPMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CHURCH PSY.D., BCBA-D (EXECUTIVE DIRECTOR)
(813) 872-6250
Entity
Organization
Contact information
Practice address
3809 N TAMPA ST, TAMPA, FL 33603-4743
(813) 876-6250
(813) 872-6078
Mailing address
5904 N ARMENIA AVE, TAMPA, FL 33603-1024
(813) 872-6250
(813) 872-6078
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024111396
—
FL
01
—
024111398
FSL WAIVER
FL
Enumeration date
09/21/2006
Last updated
10/22/2020
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