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Organization
LISA DAVIS
Active
Organization
LISA DAVIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DAVIS (OWNER)
(727) 443-0368
Entity
Organization
Contact information
Practice address
1114 ENGMAN ST, CLEARWATER, FL 33755-3219
(727) 443-0368
Mailing address
1114 ENGMAN ST, CLEARWATER, FL 33755-3219
(727) 443-0368
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905967
FL
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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