Provider Demographics
NPI:1508466533
Name:EXCEPTIONAL HEALTHCARE SERVICES CORP
Entity Type:Organization
Organization Name:EXCEPTIONAL HEALTHCARE SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:239-645-2730
Mailing Address - Street 1:4318 SW 9TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-5759
Mailing Address - Country:US
Mailing Address - Phone:239-645-2730
Mailing Address - Fax:
Practice Address - Street 1:13240 N CLEVELAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-4855
Practice Address - Country:US
Practice Address - Phone:239-645-2730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center