Organization Active NPI

Gulf Care, Inc.

  • Assisted Living Facility
  • Cape Coral, FL
National Provider Identifier
1962403287
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL7386 Issued in FL
Legal business name
GULF CARE, INC.
Practice address
1333 Santa Barbara Blvd
Cape Coral, FL 33991-2803
Phone
(239) 772-1333
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Kevin Ahmadi
Title
Executive Director
Phone
(239) 772-1333

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL7386 FL Primary
Skilled Nursing Facility 314000000X SNF1188096 FL

Addresses

Primary practice location

1333 Santa Barbara Blvd
Cape Coral, FL 33991-2803

Mailing address

1333 Santa Barbara Blvd
Cape Coral, FL 33991-2803

Other names 1

  • Gulf Coast Village Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061021000004 FL Part A Provider - Skilled Nursing Facility 4284542648 Practice locations: Cape Coral, FL
O20120605000407 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4284542648 Practice locations: Cape Coral, FL

Skilled nursing facility certification: CCN 105672

Legal name
GULF CARE, INC.
Doing business as
GULF COAST VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 28, 1989
Last certification
May 1, 2025
Beds
105 (85 certified)
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 29, 1994 in FL
Enrollment address
1333 Santa Barbara Blvd
Cape Coral, FL 33991-2803
Nursing home name
GULF COAST VILLAGE
Affiliated entity
VOLUNTEERS OF AMERICA SENIOR LIVING

Outpatient physical therapy / speech pathology certification: CCN 686668

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GULF COAST VILLAGE
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Dec 3, 2002
Last certification
Nov 4, 2019
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
1333 Santa Barbara Blvd
Cape Coral, FL 33991

Care Compare: Nursing home

Medicare Care Compare
Listed as
Gulf Coast VillageCCN 105672
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 28, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8588.8 residents per day on average
Chain
Volunteers of America Senior Living6 facilities in the chain
Special focus status
SFF
Penalties (3 years)
3Fines totaling $37,092

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0294896Gulf Coast Village1333 Santa Barbara Blvd, Cape Coral, FL 33991Certificate of waiverAug 31, 2026
10D1032482Gulf Coast Village Home Health Inc1333 Santa Barbara Blvd, Cape Coral, FL 33991Certificate of waiverOct 24, 2026

National Provider Directory

National Provider Directory

Locations

1333 Santa Barbara Blvd
Ofc
Cape Coral, FL 33991

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Ownership & related parties

All disclosed owners & managing parties 32

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Angelique Divietro Individual Operational/Managerial Control May 12, 2025
Adp of the SNF May 12, 2025
Sarah Richard Individual Operational/Managerial Control Jan 17, 2025
Adp of the SNF Jan 17, 2025
Karen Erickson Individual Corporate DirectorBoard Member Jul 1, 2022
Janet Stringfellow Individual Corporate DirectorBoard Member Jul 1, 2024
Individual Adp of the SNF Jan 1, 2025
Ryan Keller Individual Corporate OfficerVice President Jul 1, 2024
Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jul 1, 2024
Karen Hackett Individual Corporate DirectorBoard Member Jul 1, 2023
Beth Ann Mullen Individual Corporate DirectorBoard Member Jul 1, 2023
Michael W King Individual Corporate OfficerCeo Mar 5, 2020
Operational/Managerial Control Mar 5, 2020
Adp of the SNF Mar 5, 2020
Faith Ann Nutz Individual Corporate OfficerAssistant Treasurer/Secretary Sep 1, 2018
Jeanne Louise Peterson Individual Corporate DirectorBoard Member Jul 1, 2017
Voris Vigee Individual Corporate DirectorBoard Member Jul 1, 2022
David Nisivoccia Individual Corporate OfficerEvp & Coo Dec 1, 2023
Morris a Stribling Individual Corporate DirectorBoard Member Jul 1, 2024
Saltmarsh Cpas, Inc. Organization, Tampa, FL Corporation, Consulting firm Adp of the SNF Jan 1, 2025
Melissa Kittleson Individual Corporate DirectorBoard Member Jul 1, 2024
Volunteers of America Organization, Alexandria, VA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2004 100%
5% Or Greater Indirect Ownership Interest Aug 1, 2004 100%
Adp of the SNF Aug 1, 2004
Patrick N Sheridan Individual Corporate DirectorBoard Member Jul 1, 2023
John Maneval Individual Corporate DirectorBoard Member Jul 1, 2024
Volunteers of America National Services Organization, Alexandria, VA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2026 100%
Operational/Managerial Control Jan 1, 2026
Adp of the SNF May 28, 2026
Shawn Bloom Individual Corporate DirectorBoard Member Jul 1, 2017
Paul Soczynski Individual Corporate OfficerSr. Vice President Jul 1, 2024
Derrick N Perkins Individual Corporate DirectorBoard Member Jul 1, 2019
Individual Adp of the SNF Jan 1, 2025
Carmen Jackson Individual Corporate DirectorBoard Member Jul 1, 2024
Individual Adp of the SNF Jan 1, 2025
Anand R Mahadevan Individual Operational/Managerial Control Jun 1, 2020
Adp of the SNF Jun 1, 2020
Individual Adp of the SNF Jan 1, 2025
Walter Tejada Individual Corporate DirectorBoard Member Jul 1, 2024
Joseph Anthony Budzynski Individual Operational/Managerial Control Apr 1, 2012
Adp of the SNF Apr 1, 2012
Jeff Bata Individual Corporate OfficerAssistant Treasurer/Secretary Oct 24, 2025
Individual Adp of the SNF Jan 1, 2025

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1962403287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912803",
            "telephone_number": "239-772-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "AHMADI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "239-772-1333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7386",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1188096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.