Fort Myers FL Icf Opco LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

FORT MYERS FL ICF OPCO LLC

Practice address

2975 Garden St
Fort Myers, FL 33917-1883

Phone

(239) 995-5833

NPI assigned

Feb 28, 2022

Organization subpart

No

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

Authorized official

Name

Batya Gorelick

Title

Coo

Phone

(239) 995-5833

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1942956909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 SYLVAN AVE",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323301",
            "telephone_number": "201-928-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 GARDEN ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339171883",
            "telephone_number": "239-995-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MYERS FL ICF OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "GORELICK",
        "authorized_official_first_name": "BATYA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "239-995-5833"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Fort Myers, FL
• Providers in 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 Feb 28, 2022; 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.