EXCELSIOR OMEGA INC. NPI 1780825489

NPI Information

  • NPI: 1780825489
  • Provider Name: EXCELSIOR OMEGA INC.
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: BRISIANA MANOR
  • Address: 15 DADE AVE
    16 ST LUCIE AVE
    SARASOTA, FL
    ZIP 34232
  • Phone: (941) 371-4091

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NPI Details

EXCELSIOR OMEGA INC. is an assisted living facility in Sarasota, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. EXCELSIOR OMEGA INC. NPI is 1780825489. The provider is registered as an organization entity type.
The provider Is Doing Business As Brisiana Manor.

The provider's business location address is:

15 DADE AVE
16 ST LUCIE AVE
SARASOTA, FL
ZIP 34232-608
Phone: (941) 371-4091

The provider's authorized official is Jacqueline St Juste .
The authorized official title is Medicaide Eligible and has the following contact phone number (941) 371-4096.

The enumeration date for this NPI number is 3/10/2009 and was last updated on 9/27/2016.

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
1310400000XAssisted Living FacilityAL11449FLORIDAYes

What is NPI?

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This page was last updated on: 11/21/2025

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