Provider Demographics
NPI:1578785937
Name:THE CHILDREN'S HOME, INC.
Entity type:Organization
Organization Name:THE CHILDREN'S HOME, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:RICKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-864-1501
Mailing Address - Street 1:10909 MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-2511
Mailing Address - Country:US
Mailing Address - Phone:813-855-4435
Mailing Address - Fax:813-864-1325
Practice Address - Street 1:10909 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-2511
Practice Address - Country:US
Practice Address - Phone:813-855-4435
Practice Address - Fax:813-864-1325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL124038900Medicaid