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FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I INC NPI 1043323934


NPI Information

NPI: 1043323934
Provider Name: FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC

Doing Business As: SANDY PARK DEVELOPMENTAL CENTER

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 10D2266523

Address:
2975 GARDEN ST
NORTH FORT MYERS, FL
ZIP 33917
Phone: (239) 995-5833
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FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC is an intermediate care facility mentally retarded in North Fort Myers, FL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC NPI is 1043323934. The provider is registered as an organization entity type.
The provider Is Doing Business As Sandy Park Developmental Center.

The provider's business location address is:

2975 GARDEN ST
NORTH FORT MYERS, FL
ZIP 33917-883
Phone: (239) 995-5833
Fax: (239) 995-4856

The provider's authorized official is Jamie Latture Collier .
The authorized official title is Director Of Reimbursement and has the following contact phone number (601) 607-7195.

The CLIA number assigned to this NPI record is 10D2266523 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Intellectual Disabilities4071095FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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