MEDICARE: NATIONAL DEAF ACADEMY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	323P00000X	Psychiatric Residential Treatment Facility	8577	FL

General Provider Information

NPI Number	:	1306858196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL DEAF ACADEMY, LLC

Provider Business Mailing Address
First Line	:	19650 US HIGHWAY 441
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6959
Country	:	US
Telephone Number	:	352-735-9500
Fax Number	:	352-735-4939

Provider Business Practice Location Address
First Line	:	19650 US HIGHWAY 441
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6959
Country	:	US
Telephone Number	:	352-735-9500
Fax Number	:	352-735-4939

Authorized Official
Title or Position	:	SR VP CFO
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	02/23/2011

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