Provider Demographics
NPI:1366499204
Name:COMMUNITY ACCESS PROVIDERS, INC.
Entity Type:Organization
Organization Name:COMMUNITY ACCESS PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR OF LIFE SKILLS
Authorized Official - Prefix:MS
Authorized Official - First Name:AMEE'
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARTMELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-213-0446
Mailing Address - Street 1:102 E NEW HAVEN AVE
Mailing Address - Street 2:138
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-4502
Mailing Address - Country:US
Mailing Address - Phone:321-213-0446
Mailing Address - Fax:321-259-6466
Practice Address - Street 1:102 E NEW HAVEN AVE
Practice Address - Street 2:138
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-4502
Practice Address - Country:US
Practice Address - Phone:321-213-0446
Practice Address - Fax:321-259-6466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL686963796251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686963796Medicaid