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General NPI Number Information
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NPI Number | 1598447138
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Entity Type | Organization
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Legal Business Name | ECCI, LLC
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 2951 GARDEN STREET
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City | NORTH FORT MYERS
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State | FL
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Zip | 33917-1883
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Country | US
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Telephone | 239-652-5604
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Fax | 239-652-5606
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Provider Business Mailing Address
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Address Line | 1890 STATE ROAD 436 SUITE 300
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City | WINTER PARK
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State | FL
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Zip | 32792-2285
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Country | US
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Telephone | 407-645-3211
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Fax | 407-645-3011
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KENNETH SCHULTZ
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Credential |
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Telephone | 407-645-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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