Provider Demographics
NPI: | 1336920966 |
---|---|
Name: | HEALTH CARE CENTER FOR THE HOMELESS, INC. |
Entity type: | Organization |
Organization Name: | HEALTH CARE CENTER FOR THE HOMELESS, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BAKARI |
Authorized Official - Middle Name: | F |
Authorized Official - Last Name: | BURNS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 407-428-5751 |
Mailing Address - Street 1: | 232 N ORANGE BLOSSOM TRL |
Mailing Address - Street 2: | |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32805-1612 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-428-5751 |
Mailing Address - Fax: | 407-428-6204 |
Practice Address - Street 1: | 232 N ORANGE BLOSSOM TRL |
Practice Address - Street 2: | MMU2 |
Practice Address - City: | ORLANDO |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32805-1612 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-428-5751 |
Practice Address - Fax: | 407-428-6204 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-10-10 |
Last Update Date: | 2025-08-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |