Provider Demographics
NPI:1598188971
Name:SPECIAL CARE SERVICES
Entity Type:Organization
Organization Name:SPECIAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CAMPELLONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-216-8053
Mailing Address - Street 1:5100 SEAGRAPE DR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-7458
Mailing Address - Country:US
Mailing Address - Phone:772-216-8053
Mailing Address - Fax:
Practice Address - Street 1:5100 SEAGRAPE DR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-7458
Practice Address - Country:US
Practice Address - Phone:772-216-8053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
FL232737253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management