Healthcare Provider Details

I. General information

NPI: 1629195284
Provider Name (Legal Business Name): NEIGHBORLY CARE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12425 28TH ST N SUITE 200
ST PETERSBURG FL
33716-1844
US

IV. Provider business mailing address

13945 EVERGREEN AVE STE 200
CLEARWATER FL
33762-4525
US

V. Phone/Fax

Practice location:
  • Phone: 727-573-9444
  • Fax: 727-572-8214
Mailing address:
  • Phone: 727-573-9444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberNA
License Number StateFL

VIII. Authorized Official

Name: DAVID LOMAKA
Title or Position: CEO
Credential:
Phone: 727-573-9444