# DOLORES SENIOR SOCIAL CLUB LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831055961
- **Authorized official:** PEDRO JUAN MATO MARRERO RN (ADMINISTRATOR)
- **Authorized official phone:** (239) 517-2578

## Contact information

- **Practice address:** 735 NE 19TH PL, CAPE CORAL, FL 33909-7812
- **Practice address phone:** (239) 517-2578
- **Practice address fax:** (239) 208-4648
- **Mailing address:** 735 NE 19TH PL, CAPE CORAL, FL 33909-7812
- **Mailing address phone:** (239) 517-2578
- **Mailing address fax:** (239) 208-4648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/02/2026
- **Last updated:** 01/02/2026