Organization
LIBERTY CLUB SENIORS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHEL CATLIN MSW-ACSW (CHIEF ADMINISTRATOR)
(813) 991-1960
Entity
Organization
Contact information
Practice address
10329 CROSS CREEK BLVD, SUITE P, TAMPA, FL 33647-2994
(813) 991-1960
(813) 991-1961
Mailing address
10329 CROSS CREEK BLVD, SUITE P, TAMPA, FL 33647-2994
(813) 991-1960
(813) 991-1961
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
01/12/2007
Last updated
12/12/2007
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