South Central Care Provider LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

SOUTH CENTRAL CARE PROVIDER LLC

Practice address

2797 Recker Hwy
Winter Haven, FL 33880-1940

Phone

(954) 805-5488

NPI assigned

Feb 22, 2024

Organization subpart

No

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

Authorized official

Name

Diamond Belle

Title

Qwner

Phone

(954) 805-5488

Specialties & licenses 1

Addresses

Other names 1

• South Central Care Provider LLC Former legal business name

Locations

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1255197737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2797 RECKER HWY",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338801940",
            "telephone_number": "954-805-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2797 RECKER HWY",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338801940",
            "telephone_number": "954-805-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL CARE PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "BELLE",
        "authorized_official_first_name": "DIAMOND",
        "authorized_official_title_or_position": "QWNER",
        "authorized_official_telephone_number": "954-805-5488"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Care Provider LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Special Heart for Special People LLC

• Developmental Disabilities Clinic/Center in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.