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General NPI Number Information
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NPI Number | 1033891759
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Entity Type | Organization
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Legal Business Name | NEVILLE NGABE LLC
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 10140 VIA COLOMBA CIR
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City | FORT MYERS
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State | FL
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Zip | 33966-6549
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Country | US
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Telephone | 417-297-5142
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Fax |
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Provider Business Mailing Address
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Address Line | 407 E AYRE ST # 1162
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City | WILMINGTON
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State | DE
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Zip | 19804-2512
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Country | US
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Telephone | 417-297-5142
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NEVILLE NGABE
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Credential | RN
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Telephone | 417-297-5142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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