NPIMap

Organization Active NPI

Pensacola Care Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fort Walton Beach, FL
National Provider Identifier
1649279589
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
4024096 Issued in FL
Legal business name
PENSACOLA CARE INC.
Doing business as
Fort Walton Beach Developmental Center
Practice address
113 Barks Dr
Fort Walton Beach, FL 32547-6713
Phone
(850) 862-0108
Fax
(850) 862-7103
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John Patrick Finnerty
Title
Administrator
Phone
(850) 862-0108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 4024096 FL Primary

Addresses

Primary practice location

113 Barks Dr
Fort Walton Beach, FL 32547-6713

Mailing address

113 Barks Dr
Fort Walton Beach, FL 32547-6713
Phone (850) 862-0108

Other names 1

  • Fort Walton Beach Developmental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fort Walton Beach Developmental Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649279589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BARKS DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476713",
            "telephone_number": "850-862-0108",
            "fax_number": "850-862-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BARKS DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476713",
            "telephone_number": "850-862-0108",
            "fax_number": "850-862-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FINNERTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-862-0108",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "4024096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Walton Beach Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • 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.