Provider Demographics
NPI:1407219538
Name:ACADEMY & CARING CENTERS OF AMERICA
Entity Type:Organization
Organization Name:ACADEMY & CARING CENTERS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAYEYSI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMENATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-887-2092
Mailing Address - Street 1:3351 MARINATOWN LN
Mailing Address - Street 2:UNIT 200
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7066
Mailing Address - Country:US
Mailing Address - Phone:239-887-2092
Mailing Address - Fax:239-208-4533
Practice Address - Street 1:3351 MARINATOWN LN
Practice Address - Street 2:UNIT 200
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7066
Practice Address - Country:US
Practice Address - Phone:239-887-2092
Practice Address - Fax:239-208-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid