Organization
SANTA BARBARA SOCIAL CLUB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS L. AVILA (PRESIDENT)
(786) 479-2000
Entity
Organization
Contact information
Practice address
2135 SANTA BARBARA BLVD STE 106-108, CAPE CORAL, FL 33991-4359
(239) 984-2916
(239) 842-6787
Mailing address
9321 SW 174TH ST, PALMETTO BAY, FL 33157-5716
(786) 479-2000
(239) 842-6787
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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