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NPI 1821137985 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Longwood, FL
Provider details
- NPI number
- 1821137985
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Corey Manuel, Program Director(407) 774-2284
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
740 Florida Central Pkwy
Ste # 1028
Longwood, FL 32750-7651
Phone: (407) 774-2284
Fax: (407) 774-2285
Street-level locationGet directions
Mailing address
740 Florida Central Pkwy
Longwood, FL 32750-7651
Registry dates
- Enumerated
- 2007-02-05
- Last updated
- 2010-12-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.