Organization
EXCELSIOR OMEGA INC
Active
Other names
brisiana manor
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE DORELIEN (MANAGER)
(941) 371-4091
Entity
Organization
Contact information
Practice address
16 SAINT LUCIE AVE, SARASOTA, FL 34232-1636
(941) 371-4091
(941) 460-4387
Mailing address
16 SAINT LUCIE AVE, SARASOTA, FL 34232-1636
(941) 371-4091
(941) 460-4387
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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