FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC (NPI# 1043323934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043323934 |
| Entity Type | Organization |
| Organization Name | FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC |
| Other Organization Name | SANDY PARK DEVELOPMENTAL CENTER |
| Practice Address |
2975 Garden St North Fort Myers FL 33917-1883 |
| Mailing Address |
751 Avignon Dr Suite I Ridgeland MS 39157-5161 |
| Practice Telephone | 2399955833 |
| Practice Fax Number | 2399954856 |
| Mailing Telephone | 6016077195 |
| Mailing Fax Number | 6016077196 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JAMIE LATTURE COLLIER (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 6016077195 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 4071095 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Sandy Park Developmental Center | Doing Business As Name - Organization |
| Street Address |
2975 GARDEN ST |
| City | NORTH FORT MYERS |
| State | FL |
| Zip Code | 33917-1883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508423070 | Lisa Marie Ortiz-rivera | Registered Nurse | 15150 Piping Plover Ct 103, North Fort Myers, FL 33917 | 2019-05-21 |
| 1407124571 | Lorne Kevin Howell | Custodial Care Facility | 6410 Pga Drive, North Fort Myers, FL 33917 | 2011-12-05 |
| 1124267026 | Mary Christine Gatens | Social Worker | 2108 Lakeville, Fort Myers, FL 33917 | 2009-02-17 |
| 1417143496 | Pine Island Chiropractic Inc | Chiropractor | 5781 Bayshore Road, #103, North Fort Myers, FL 33917 | 2007-09-24 |
| 1174138176 | Claudia Rodriguez | Massage Therapist | 7728 Mcdaniel Dr, North Fort Myers, FL 33917-1930 | 2020-09-15 |
| 1760092605 | Michael Patrick Durham | Nurse Practitioner | 17501 Wells Rd, North Fort Myers, FL 33917-2108 | 2020-08-05 |
| 1043596521 | Kim Theresa Traugott | Veterinarian | 17740 Sabal Palm Dr, North Fort Myers, FL 33917-2219 | 2011-10-27 |
| 1336687573 | Luke Balkun | Behavior Technician | 2262 Westwood Rd, N Fort Myers, FL 33917-2536 | 2017-02-08 |
| 1659741825 | Amy Muniz | Registered Nurse | 2331 Westwood Rd, North Fort Myers, FL 33917-2537 | 2015-10-01 |
| 1912221383 | Cape Coral Eye Center, P.a. | Optometrist | 5781 Bayshore Rd, Suite 101, N Fort Myers, FL 33917-3003 | 2010-03-15 |
| Find all providers in zip 33917 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962009019 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 1045 Mar Walt Dr, Fort Walton Beach, FL 32547-6738 | 2020-10-01 |
| 1952919557 | The Vinglo House LLC | Intermediate Care Facility, Mentally Retarded | 1862 Finn Hill Dr, Boynton Beach, FL 33426-9329 | 2020-07-20 |
| 1487290730 | Noal Group Home, Inc | Intermediate Care Facility, Mentally Retarded | 13379 Key Lime Blvd, West Palm Beach, FL 33412-2150 | 2019-11-21 |
| 1770055980 | National Mentor Healthcare LLC | Intermediate Care Facility, Mentally Retarded | 1275 N Rainbow Loop, Lecanto, FL 34461-8893 | 2018-12-28 |
| 1871993899 | Diomar Anover | Intermediate Care Facility, Mentally Retarded | 17812 Wendy Sue Ave, Hudson, FL 34667-5917 | 2014-08-27 |
| 1972856011 | The Mentor Network | Intermediate Care Facility, Mentally Retarded | 1725 Fifth St, Daytona Beach, FL 32117-5107 | 2012-10-25 |
| 1366798290 | Barc Housing Inc. | Intermediate Care Facility, Mentally Retarded | 2750 Sw 75th Ave, Davie, FL 33314-1008 | 2012-07-30 |
| 1255658365 | 98 | Intermediate Care Facility, Mentally Retarded | 11314 Mahopac Rd, Weeki Wachee, FL 34614-3562 | 2010-04-28 |
| 1245404250 | Marcia A. Howell | Intermediate Care Facility, Mentally Retarded | 17305 Blooming Fields Dr, Land O Lakes, FL 34638-7222 | 2008-04-22 |
| 1497928774 | New Vue LLC Dba Key Pine Village | Intermediate Care Facility, Mentally Retarded | 6457 W Norvell Bryant Hwy, Crystal River, FL 34429-9413 | 2008-04-08 |
| Find all providers with the same taxonomy | ||||
| City | NORTH FORT MYERS |
| Zip Code | 33917 |
Please comment or provide details below to improve the information on FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.