Organization
CLOVERDALE INN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WELLS MEDICAL ASSISTANT (ADMINISTRATOR)
(813) 598-7628
Entity
Organization
Contact information
Practice address
1114 W COUNTY LINE RD, LUTZ, FL 33558-5032
(813) 949-8999
Mailing address
1114 W COUNTY LINE RD, LUTZ, FL 33558-5032
(813) 949-8999
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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