McClusky Enterprises Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MCCLUSKY ENTERPRISES INC.

Practice address

110B Lithia Pinecrest Rd Ste B
Brandon, FL 33511-5306

Phone

(813) 653-4072

Fax

(813) 661-4456

NPI assigned

Jul 28, 2008

Last updated

Jul 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas James McClusky, BCBA

Title

Behavior Analyst

Phone

(813) 653-4072

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1578728770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110-B LITHIA PINECREST ROAD SUITE B",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115300",
            "telephone_number": "813-653-4072",
            "fax_number": "813-661-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110B LITHIA PINECREST RD STE B",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115306",
            "telephone_number": "813-653-4072",
            "fax_number": "813-661-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLUSKY ENTERPRISES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "MCCLUSKY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "813-653-4072",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "671327196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla McBeath
• Diane McCarthy
• Robert Forestal McCauley III
• Kylie Jean McCloe, MS CCCSLP
• Angela Sue McClure, LMHC
• Nicole Joy McConnell, M.D.
• Elizabeth McCormack
• Blair-Tiffany McCormick, LCSW
• William J McCormick, MS, PT
• Kim McCullough, F.N.P.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Brandon, FL
• Providers in Brandon, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.