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General NPI Number Information
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NPI Number | 1831184647
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Entity Type | Organization
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Legal Business Name | MCLANE BRIAN, LLC
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 10 GLEN ED PROFESSIONAL PARK
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City | GLEN CARBON
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State | IL
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Zip | 62034-3333
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Country | US
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Telephone | 800-853-5292
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Fax | 855-230-5482
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Provider Business Mailing Address
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Address Line | 2203 N LOIS AVE STE 700
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City | TAMPA
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State | FL
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Zip | 33607-2387
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Country | US
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Telephone | 813-850-0042
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Fax | 813-850-0043
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Authorized Official
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Title or Position | CREDENTIALING DIRECTOR
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Name | EMMA DE JESUS
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Credential |
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Telephone | 813-850-0042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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