Health Care Center for the Homeless, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Orlando, FL
NPI 1952869968 · NPPES record last updated Mar 8, 2019
Key facts
- NPI
- 1952869968
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- HEALTH CARE CENTER FOR THE HOMELESS, INC.
- Practice address
- 4426 Old Winter Garden Rd
Orlando, FL 32811 - Phone
- (407) 428-5157
- NPI assigned
- Mar 8, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- HEALTH CARE CENTER FOR THE HOMELESS, INC.
Authorized official
- Name
- Dr. Chianta Shaw Lindsey, DNP, APRN
- Title
- Chief Operating Officer
- Phone
- (407) 428-5751
Owners & managing parties with NPI records 1
-
Chaney B Gordy, D.M.D.
Other NPIs on the same Medicare enrollment 7
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 13
Practitioners 69
-
Giselle Campos, FNP
-
Janet M Hutchison, ARNP
-
Adaliz Olmeda, ARNP
-
Lena Rivera Anderson, PSY.D.
-
Eric Joseph Bell, LCSW; LICSW
-
Arthur E Betancourt, PSYD
-
Francoeur Cadet, D.O
-
Pamela Lynn Cooper, PMHNP-BC
-
Noeline Jean-Marie Coore, LCSW
-
Jane Ann Dacri, ARNP
-
Roshni Dasan, APRN
-
Michelle Rene Demenkow, PH.D.
-
Maya Duffy, LCSW
-
Enitan O Ekwotafia, ARNP
-
Kendra C Ferrille, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL
Federally qualified health center certification: CCN 681171
- Legal name
- HEALTH CARE CENTER FOR THE HOMELESS INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 19, 2020
- Last certification
- Feb 19, 2020
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 4426 Old Winter Garden Rd
Orlando, FL 32811-4211
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Jason Rimes |
Corporate Director |
Aug 5, 2010 | |
| Selena Williams |
Corporate Director |
Dec 31, 2010 | |
| Bakari Burns |
Corporate Director |
Aug 5, 2010 | |
| W-2 Managing Employee |
Aug 5, 2010 | ||
| Cliff Morris |
Corporate Director |
Aug 5, 2010 | |
| Pierre Arsenec |
Corporate Director |
Dec 31, 2010 | |
| Chaney B Gordy |
Corporate Director |
Nov 5, 2004 | |
| Antonio Arias |
Corporate Director |
Aug 5, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101019001089 | FL | Part B Supplier - Clinic/Group Practice | 6103895107 |
Receives reassigned benefits from 106 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kissimmee, FL; Orlando, FL |
| O20200219002138 | FL | Part a Provider - Federally Qualified Health Center (FQHC) | 6103895107 | Practice locations: Orlando, FL |
National Provider Directory
- Tax ID family
- Health Care Center for the Homeless Inc
- Part of
- Health Care Center for the Homeless Inc
Locations
2711 N Orange Blossom Trl
Ste A
Kissimmee, FL 34744
232 N Orange Blossom Trl
#2
Orlando, FL 32805
9833 E Colonial Dr
Orlando, FL 32817
Phone (407) 876-6699
3100 Evans Trojans Way
Orlando, FL 32808
232 N Orange Blossom Trl
#1
Orlando, FL 32805
6001 Vineland Rd
Ste 112
Orlando, FL 32819
Phone (407) 271-8845
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
4426 Old Winter Garden Rd
Orlando, FL 32811
Mailing address
232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone (407) 428-5751
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 687429100 | Medicaid | FL |
Other names
- Orange Blossom Family Health
Other providers in Orlando, FL
- Health Care Center for the Homeless, Inc.
- Health Care Center for the Homeless, Inc.
- Health Care Center for the Homeless, Inc.
- Health Care Center for the Homeless, Inc.
- Health Care Center for the Homeless, Inc.
- Health Care Center for the Homeless, Inc.
- Health Center of Orlando Inc
- Health Diagnostics of Orlando LLC
- Health Effects Inc
- Health Enrichment Lifeskille Program
All providers in Orlando, FL · Federally Qualified Health Center (FQHC) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.