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Organization

ELSYOFF CARE CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAILIN FREEMAN (OWNER)
(239) 312-8316
Entity
Organization

Contact information

Practice address
1727 NW 19TH TER, CAPE CORAL, FL 33993-4915
(239) 312-8316
(239) 312-8320
Mailing address
1727 NW 19TH TER, CAPE CORAL, FL 33993-4915
(239) 312-8316
(239) 312-8320

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NA
FL
Enumeration date
11/02/2020
Last updated
11/02/2020
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