Active NPI
Gulf Care, Inc.
- Assisted Living Facility
- Cape Coral, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL7386
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Village
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Aug 28, 1989
- Medicare certification status
- Active
- Certified beds
- 85
- Chain
- Volunteers of America Senior Living
- Special focus status
- SFF
- Penalties (3 years)
- 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0294896 | Gulf Coast Village | Certificate of waiver | Aug 31, 2026 |
| 10D1032482 | Gulf Coast Village Home Health Inc | Certificate of waiver | Oct 24, 2026 |
National Provider Directory
National Provider DirectoryLocations
1333 Santa Barbara Blvd
Ofc
Cape Coral, FL 33991
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Angelique Divietro | Operational/Managerial Control | May 12, 2025 | |
| Adp of the SNF | May 12, 2025 | ||
| Sarah Richard | Operational/Managerial Control | Jan 17, 2025 | |
| Adp of the SNF | Jan 17, 2025 | ||
| Karen Erickson | Corporate Director | Jul 1, 2022 | |
| Janet Stringfellow | Corporate Director | Jul 1, 2024 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Ryan Keller | Corporate Officer | Jul 1, 2024 | |
| Operational/Managerial Control | Jul 1, 2024 | ||
| Adp of the SNF | Jul 1, 2024 | ||
| Karen Hackett | Corporate Director | Jul 1, 2023 | |
| Beth Ann Mullen | Corporate Director | Jul 1, 2023 | |
| Michael W King | Corporate Officer | Mar 5, 2020 | |
| Operational/Managerial Control | Mar 5, 2020 | ||
| Adp of the SNF | Mar 5, 2020 | ||
| Faith Ann Nutz | Corporate Officer | Sep 1, 2018 | |
| Jeanne Louise Peterson | Corporate Director | Jul 1, 2017 | |
| Voris Vigee | Corporate Director | Jul 1, 2022 | |
| David Nisivoccia | Corporate Officer | Dec 1, 2023 | |
| Morris a Stribling | Corporate Director | Jul 1, 2024 | |
| Saltmarsh Cpas, Inc. | Adp of the SNF | Jan 1, 2025 | |
| Melissa Kittleson | Corporate Director | Jul 1, 2024 | |
| Volunteers of America | 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 | Corporate Director | Jul 1, 2023 | |
| John Maneval | Corporate Director | Jul 1, 2024 | |
| Volunteers of America National Services | 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 | Corporate Director | Jul 1, 2017 | |
| Paul Soczynski | Corporate Officer | Jul 1, 2024 | |
| Derrick N Perkins | Corporate Director | Jul 1, 2019 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Carmen Jackson | Corporate Director | Jul 1, 2024 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Anand R Mahadevan | Operational/Managerial Control | Jun 1, 2020 | |
| Adp of the SNF | Jun 1, 2020 | ||
| Adp of the SNF | Jan 1, 2025 | ||
| Walter Tejada | Corporate Director | Jul 1, 2024 | |
| Joseph Anthony Budzynski | Operational/Managerial Control | Apr 1, 2012 | |
| Adp of the SNF | Apr 1, 2012 | ||
| Jeff Bata | Corporate Officer | Oct 24, 2025 | |
| 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.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1245238245
Adp of the SNF, Operational/Managerial Control
-
- Foot & Ankle Surgery Podiatrist
- San Antonio, TX
- NPI 1538194485
Corporate Director
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.