Florry Creative Care Corporation

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL11825 Issued in FL

Legal business name

FLORRY CREATIVE CARE CORPORATION

Practice address

415 N Wilder Rd
Plant City, FL 33566-7544

Phone

(813) 441-4761

Fax

(866) 240-5666

NPI assigned

Dec 31, 2007

Organization subpart

Yes

Parent organization

FORRY CREATIVE CARE CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cherry Kay Hallback

Title

Program Coordinator

Phone

(813) 650-8242

Specialties & licenses 4

Addresses

Other identifiers 3

Tax ID family

Florry Creative Care Corporation5 organizations share this tax ID, including this one

Part of

Florry Creative Care Corporation

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Creative Home Health

  • Home Health Agency
  • Plant City, FL
  • NPI 1215793997
  NPD tax ID
• Florry Creative Care

  • Assisted Living Facility (Mental Illness)
  • Plant City, FL
  • NPI 1528417391
  NPD tax ID
• Florry Creative Care Corp

  • Attendant Care Provider
  • Plant City, FL
  • NPI 1760896278
  NPD tax ID
• Florry Creative Care Corporation

  • Assisted Living Facility
  • Plant City, FL
  • NPI 1427393289
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1235314915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5636",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335630047",
            "telephone_number": "813-650-8242",
            "fax_number": "813-650-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N WILDER RD",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335667544",
            "telephone_number": "813-441-4761",
            "fax_number": "866-240-5666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5111 Smith Ryals Rd",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335673749",
            "country_code": "US",
            "telephone_number": "813-650-8242",
            "fax_number": "813-650-8242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORRY CREATIVE CARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORRY CREATIVE CARE CORPORATION",
        "enumeration_date": "2007-12-31",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "HALLBACK",
        "authorized_official_first_name": "CHERRY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "813-650-8242",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL11825",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "692691696",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002437100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104395400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6292691696",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florida United Methodist Childrens Home, Inc.
• Florida Urgent Care Center, LLC.
• Florida Urgent Care Center, LLC.
• Florry Creative Care
• Florry Creative Care Corp
• Florry Creative Care Corporation
• Forever Grace Services LLC
• Francis a Derito M.D.
• Chasity Aisha Franklin, APRN
• Brett Frazier, M.D.

• Assisted Living Facility (Mental Illness) in Plant City, FL
• Providers in Plant City, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.