1407219538 NPI number — ACADEMY & CARING CENTERS OF AMERICA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407219538 NPI number — ACADEMY & CARING CENTERS OF AMERICA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACADEMY & CARING CENTERS OF AMERICA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407219538
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3351 MARINATOWN LN
Provider Second Line Business Mailing Address:
UNIT 200
Provider Business Mailing Address City Name:
NORTH FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33903-7066
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-887-2092
Provider Business Mailing Address Fax Number:
239-208-4533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3351 MARINATOWN LN
Provider Second Line Business Practice Location Address:
UNIT 200
Provider Business Practice Location Address City Name:
NORTH FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33903-7066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-887-2092
Provider Business Practice Location Address Fax Number:
239-208-4533
Provider Enumeration Date:
04/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CARMENATE
Authorized Official First Name:
DAYEYSI
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
239-887-2092

Provider Taxonomy Codes

  • Taxonomy code: 385HR2065X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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