Organization
CARE CLUB OF COLLIER COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUANNE WAHLSTROM LPN (EXECTUVIE DIRECTOR)
(239) 353-1994
Entity
Organization
Contact information
Practice address
1800 SANTA BARBARA BLVD, NAPLES, FL 34116-5444
(239) 353-1994
(239) 455-8507
Mailing address
1800 SANTA BARBARA BLVD, NAPLES, FL 34116-5444
(239) 353-1994
(239) 455-8507
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
AD8750
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
676919500
—
FL
Enumeration date
10/02/2012
Last updated
10/02/2012
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