MEDICARE: EXCEPTIONAL CARE OF THE TREASURE COAST, INC

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821619214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEPTIONAL CARE OF THE TREASURE COAST, INC

Provider Business Mailing Address
First Line	:	PO BOX 650075
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32965-0075
Country	:	US
Telephone Number	:	772-501-3033
Fax Number	:	772-217-2199

Provider Business Practice Location Address
First Line	:	101 N US HIGHWAY 1 STE 210
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4262
Country	:	US
Telephone Number	:	772-501-3033
Fax Number	:	772-217-2199

Authorized Official
Title or Position	:	PRESIDENT/DIRECTOR
Name	:	MS. YOLANDA YVETTE TURNER
Credential	:
Telephone Number	:	772-501-3033

Provider Enumeration Date	:	04/27/2020
Last Update Date	:	04/05/2023

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