NPIMap

Organization Active NPI

Excelsior Omega Inc

  • Foster Care Agency
  • Sarasota, FL
National Provider Identifier
1588115331
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
EXCELSIOR OMEGA INC
Practice address
16 Saint Lucie Ave
Sarasota, FL 34232-1636
Phone
(941) 371-4091
Fax
(941) 460-4387
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Jacqueline Dorelien
Title
Manager
Phone
(941) 371-4091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X Primary

Addresses

Primary practice location

16 Saint Lucie Ave
Sarasota, FL 34232-1636

Mailing address

16 Saint Lucie Ave
Sarasota, FL 34232-1636
Phone (941) 371-4091

Other names 1

  • brisiana manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Excelsior Omega 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.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1588115331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SAINT LUCIE AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342321636",
            "telephone_number": "941-371-4091",
            "fax_number": "941-460-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SAINT LUCIE AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342321636",
            "telephone_number": "941-371-4091",
            "fax_number": "941-460-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR OMEGA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "DORELIEN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-371-4091"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "brisiana manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.