Provider Demographics
NPI:1164745667
Name:CAM ENTERPRISES, LLC
Entity Type:Organization
Organization Name:CAM ENTERPRISES, LLC
Other - Org Name:PREFERRED PRIVATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-465-0500
Mailing Address - Street 1:540 NW UNIVERSITY BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2281
Mailing Address - Country:US
Mailing Address - Phone:772-465-0500
Mailing Address - Fax:772-293-9850
Practice Address - Street 1:540 NW UNIVERSITY BLVD STE 206
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2281
Practice Address - Country:US
Practice Address - Phone:772-465-0500
Practice Address - Fax:772-293-9850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211431251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000788000OtherMEDECAID WAIVER