Provider Demographics
NPI:1649335258
Name:COMMUNITY OPTIONS OF CENTRAL FLORIDA
Entity type:Organization
Organization Name:COMMUNITY OPTIONS OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEANORE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-999-9039
Mailing Address - Street 1:1310 W. COLONIAL DR
Mailing Address - Street 2:# 8
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804
Mailing Address - Country:US
Mailing Address - Phone:407-999-9039
Mailing Address - Fax:407-999-5608
Practice Address - Street 1:1310 W COLONIAL DR
Practice Address - Street 2:# 8
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7139
Practice Address - Country:US
Practice Address - Phone:407-999-9039
Practice Address - Fax:407-999-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229842251E00000X
FL251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF=========001Medicaid