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NPI Code Detail

MEDICARE: REFLECTIONS CARE CLUB, INC

MEDICARE: REFLECTIONS CARE CLUB, 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
1261QA0600XAdult Day Care Clinic/Center9094FL

General Provider Information

NPI Number : 1225274582
Entity Type Code : Organization
Provider Name (Legal Business Name) : REFLECTIONS CARE CLUB, INC
Provider Business Mailing Address
First Line : 5711 INDEPENDENCE CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4402
Country : US
Telephone Number : 239-498-6888
Fax Number : 239-466-6209
Provider Business Practice Location Address
First Line : 5711 INDEPENDENCE CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4402
Country : US
Telephone Number : 239-498-6888
Fax Number : 239-466-6209
Authorized Official
Title or Position : OWNER
Name : TARA HOOLEY-SEGO
Credential :
Telephone Number : 239-498-6888
Provider Enumeration Date : 12/16/2008
Last Update Date : 12/16/2008

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Directions to “REFLECTIONS CARE CLUB, INC ” Practice Location

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