| Entity Name: | MCCLUSKY ENTERPRISES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Inactive |
| Date Filed: | 20 Apr 1993 (32 years ago) |
| Document Number: | N93000001787 |
| FEI/EIN Number | 593181989 |
| Address: | 16118 Coquina Bay Lane, Wimauma, FL, 33598, US |
| Mail Address: | 16118 Coquina Bay Lane, Wimauma, FL, 33598, US |
| ZIP code: | 33598 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578728770 | 2008-07-28 | 2008-07-28 | 110-B LITHIA PINECREST ROAD SUITE B, BRANDON, FL, 335115300, US | 110B LITHIA PINECREST RD STE B, BRANDON, FL, 335115306, US | |||||||||||||||||||||
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| Phone | +1 813-653-4072 |
| Fax | 8136614456 |
Authorized person
| Name | MR. THOMAS JAMES MCCLUSKY |
| Role | BEHAVIOR ANALYST |
| Phone | 8136534072 |
Taxonomy
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 671327196 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMAS J. MCCLUSKY | Agent | 16118 Coquina Bay Lane, Wimauma, FL, 33598 |
| Name | Role | Address |
|---|---|---|
| MCCLUSKY THOMAS J | Director | 4334 SWIFT CIRCLE, VALRICO, FL, 33596 |
| MCCLUSKY NANCY | Director | 4334 SWIFT CIRCLE, VALRICO, FL, 33596 |
| MCCLUSKY JOSEPH B | Director | 200 N 52ND AVE, HOLLYWOOD, FL |
| MCCLUSKY ELIZABETH | Director | 200 N 52ND AVE, HOLLYWOOD, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-05-07 | No data | No data |
| CANCEL ADM DISS/REV | 2010-02-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
