MEDICARE: GLO-LIZ INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1033493887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLO-LIZ INC

Provider Business Mailing Address
First Line	:	1420 N 17TH ST
Second Line	:
City	:	KINGSVILLE
State	:	TX
Zip	:	78363-4087
Country	:	US
Telephone Number	:	361-595-5555
Fax Number	:	361-595-5555

Provider Business Practice Location Address
First Line	:	1420 N 17TH ST
Second Line	:
City	:	KINGSVILLE
State	:	TX
Zip	:	78363-4087
Country	:	US
Telephone Number	:	361-595-5555
Fax Number	:	361-595-5555

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. ELIZABETH GARZA
Credential	:
Telephone Number	:	361-595-5555

Provider Enumeration Date	:	09/28/2011
Last Update Date	:	09/28/2011

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Directions to “GLO-LIZ INC ” Practice Location

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