Provider Demographics
NPI:1588961882
Name:EXCEPTIONAL CARE WITHIN
Entity type:Organization
Organization Name:EXCEPTIONAL CARE WITHIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-520-1792
Mailing Address - Street 1:3494 HEATH DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-3097
Mailing Address - Country:US
Mailing Address - Phone:407-520-1792
Mailing Address - Fax:386-218-4036
Practice Address - Street 1:3494 HEATH DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-3097
Practice Address - Country:US
Practice Address - Phone:407-520-1792
Practice Address - Fax:386-218-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251S00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373H00000XMedicaid
FL372500000XMedicaid
FL3747A0650XMedicaid
FL385HR2065XMedicaid
FL251S00000XMedicaid
FL3747P1801XMedicaid
FL376J00000XMedicaid
FL385H00000XMedicaid
FL372600000XMedicaid
FL385HR2060XMedicaid
FL385HR2055XMedicaid
FL251C00000XMedicaid
FL347C00000XMedicaid