Provider Demographics
NPI:1609640382
Name:THE FLORIDA INSTITUTE FOR COMMUNITY INCLUSION
Entity type:Organization
Organization Name:THE FLORIDA INSTITUTE FOR COMMUNITY INCLUSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:JESTER
Authorized Official - Suffix:
Authorized Official - Credentials:CESP
Authorized Official - Phone:407-577-0494
Mailing Address - Street 1:365 AULIN AVE
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9401
Mailing Address - Country:US
Mailing Address - Phone:407-577-0494
Mailing Address - Fax:
Practice Address - Street 1:365 AULIN AVE
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9401
Practice Address - Country:US
Practice Address - Phone:407-577-0494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE FLORIDA INSTITUTE FOR COMMUNITY INCLUSION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child