Healthcare Provider Details

I. General information

NPI: 1023501145
Provider Name (Legal Business Name): SPECIAL CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 SEAGRAPE DR
FORT PIERCE FL
34982
US

IV. Provider business mailing address

5100 SEAGRAPE DR
FORT PIERCE FL
34982-7458
US

V. Phone/Fax

Practice location:
  • Phone: 772-222-7301
  • Fax: 866-371-0856
Mailing address:
  • Phone: 772-222-7301
  • Fax: 866-371-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSE ANN CAMPELLONE
Title or Position: CEO
Credential:
Phone: 772-222-7301