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
N Ft Myers, FL 33917-1883

Phone

(239) 995-5833

Fax

(239) 995-4856

NPI assigned

Nov 17, 2005

Last updated

Jul 11, 2016By 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

(972) 931-3800

Specialties & licenses 1

Addresses

Other identifiers 1

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
  • North Fort Myers, FL
  • NPI 1043323934
  NPD tax ID

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1427030253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 W PLANO PKWY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934823",
            "telephone_number": "972-931-3800",
            "fax_number": "972-767-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 GARDEN ST",
            "city": "N FT 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": "2005-11-17",
        "last_updated": "2016-07-11",
        "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": "972-931-3800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "FL",
            "license": "4071095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028000300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandy Park Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Marie Cootware-Williams, LCSW
• Curt W Furbee DC PA
• Dagnan Behavioral Consultants
• Diamond Medical Services, Inc
• Florida Fitness and Rehabilitation, Inc.
• Curt Wayne Furbee, DC
• Craig Patrick Gindele, DC
• Bradley A Habuda, DPM
• Joan Spinner Haynes, M.D.
• Joseph Aloise, D.O.,P.a.

• Intellectual Disabilities Intermediate Care Facility in N Ft Myers, FL
• Providers in N Ft 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 Jul 11, 2016; 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.