Florida Preferred Care Developmental Centers I, Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

4071095 Issued in FL

Legal business name

FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC

Doing business as

Sandy Park Developmental Center

Practice address

2975 Garden St
North Fort Myers, FL 33917-1883

Phone

(239) 995-5833

Fax

(239) 995-4856

NPI assigned

Aug 16, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jamie Latture Collier

Title

Director of Reimbursement

Phone

(601) 607-7195

Specialties & licenses 1

Addresses

Other names 1

• Sandy Park Developmental Center Doing business as

Tax ID family

Florida Preferred Care Developmental Centers I Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Florida Preferred Care Developmental Centers I, Inc.

  dba Sandy Park Developmental Center

  • Intellectual Disabilities Intermediate Care Facility
  • N Ft Myers, FL
  • NPI 1427030253
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043323934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 AVIGNON DR",
            "address_2": "SUITE I",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575161",
            "telephone_number": "601-607-7195",
            "fax_number": "601-607-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 GARDEN ST",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339171883",
            "telephone_number": "239-995-5833",
            "fax_number": "239-995-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "LATTURE",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "601-607-7195",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "FL",
            "license": "4071095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandy Park Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual Disabilities Intermediate Care Facility in North Fort Myers, FL
• Providers in North Fort Myers, FL by specialty
• Intellectual Disabilities Intermediate Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.