NPIMap

Organization Active NPI

The Pavilion at Healthpark LLC

  • Psychiatric Hospital
  • Fort Myers, FL
National Provider Identifier
1972899987
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
THE PAVILION AT HEALTHPARK LLC
Practice address
9241 Park Royal Drive
Fort Myers, FL 33908
Phone
(239) 985-2700
Fax
(239) 985-2790
NPI assigned
Jun 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
Brian P. Farley
Title
VP & Secretary
Phone
(615) 861-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X FL Primary

Addresses

Primary practice location

9241 Park Royal Drive
Fort Myers, FL 33908

Mailing address

4020 Aspen Grove Dr Ste 900
Franklin, TN 37067-3134
Phone (615) 861-6000

Other names 1

  • Park Royal Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110818000051 FL Part A Provider - Hospital 8022153949 Practice locations: Fort Myers, FL

Hospital certification: CCN 104074

Legal name
THE PAVILION AT HEALTHPARK LLC
Doing business as
PARK ROYAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
May 30, 2012
Last certification
Oct 18, 2019
Beds
126
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
9241 Park Royal Dr
Fort Myers, FL 33908-9204
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Park Royal HospitalCCN 104074
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Pavilion at Healthpark LLC2 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.

Locations

2776 Cleveland Ave
#3W
Fort Myers, FL 33901
Phone (239) 336-6160

2665 Cleveland Ave
Ste 201
Fort Myers, FL 33901
Phone (239) 337-1065

671 Goodlette Rd
#30
Naples, FL 34102
Phone (239) 985-2760

Networks

  • HealthSun Health Plans Network
  • 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)…
  • 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)

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Deborah S Kraemer Individual W-2 Managing EmployeeVP of Business Office Operations Jun 11, 2012
Amber Hentz Individual W-2 Managing EmployeeFacility Ceo Jan 3, 2022
Todd S Young Individual Corporate OfficerVice President & Treasurer Oct 27, 2025
Acadia Florida Holdco LLC Organization, Franklin, TN LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2024 100%
Acadia Healthcare Company Inc Organization, Franklin, TN Corporation, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Stacie L Harty Individual W-2 Managing EmployeeVice President of Managed Care Jun 18, 2018
Brian Philip Farley Individual Corporate OfficerVice President & Secretary Jul 26, 2023
Timothy a Sides Individual W-2 Managing EmployeeSenior VP Operations & Finance Jun 5, 2023
Debra K Osteen Individual Corporate OfficerPresident Jan 20, 2026

Facilities with the same owner 59

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 59

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1972899987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 ASPEN GROVE DR STE 900",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673134",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9241 PARK ROYAL DRIVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33908",
            "telephone_number": "239-985-2700",
            "fax_number": "239-985-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PAVILION AT HEALTHPARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Royal Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park Royal Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.