El Shaddai Care Community
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Lehigh Acres, FL. Organization (NPI-2).
Details
- NPI
- 1083583009
- Entity type
- Organization (NPI-2)
- Legal business name
- El Shaddai Care Community
- Organization subpart
- No
- Enumeration date
- Oct 30, 2025
- Certification date
- Oct 30, 2025
- Last updated
- Oct 30, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
4204 6th St WLehigh Acres, FL 33971-1218
Phone 239-810-1879
Mailing address
4204 6th St WLehigh Acres, FL 33971-1218
Phone 239-810-1879
Authorized official
Channedieuline Gabelus
Ceo
2398515397
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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