Organization
FLORIDA PREFERRED CARE DEVELOPMENTAL CENTERS I, INC.
Active
Other names
Sandy Park Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMIE LATTURE COLLIER (DIRECTOR OF REIMBURSEMENT)
(972) 931-3800
Entity
Organization
Contact information
Practice address
2975 GARDEN ST, N FT MYERS, FL 33917-1883
(239) 995-5833
(239) 995-4856
Mailing address
5420 W PLANO PKWY, PLANO, TX 75093-4823
(972) 931-3800
(972) 767-6222
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
4071095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028000300
—
FL
Enumeration date
11/17/2005
Last updated
07/11/2016
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