Provider Demographics
NPI:1831399526
Name:HILLSBOROUGH ASSOCIATION FOR RETARDED CITIZENS,INC
Entity type:Organization
Organization Name:HILLSBOROUGH ASSOCIATION FOR RETARDED CITIZENS,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:PANNULLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-931-9100
Mailing Address - Street 1:PO BOX 9537
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33674-9537
Mailing Address - Country:US
Mailing Address - Phone:813-931-9100
Mailing Address - Fax:813-915-9083
Practice Address - Street 1:2714 W KIRBY ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3300
Practice Address - Country:US
Practice Address - Phone:813-931-9100
Practice Address - Fax:813-915-9083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 320900000X, 343900000X, 385HR2060X
FL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024102496Medicaid
FL024102498Medicaid