Care Club of Collier County, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

AD8750 Issued in FL

Legal business name

CARE CLUB OF COLLIER COUNTY, INC.

Practice address

1800 Santa Barbara Blvd
Naples, FL 34116-5444

Phone

(239) 353-1994

Fax

(239) 455-8507

NPI assigned

Oct 2, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Luanne Wahlstrom, LPN

Title

Exectuvie Director

Phone

(239) 353-1994

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1992056873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SANTA BARBARA BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165444",
            "telephone_number": "239-353-1994",
            "fax_number": "239-455-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SANTA BARBARA BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165444",
            "telephone_number": "239-353-1994",
            "fax_number": "239-455-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE CLUB OF COLLIER COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "WAHLSTROM",
        "authorized_official_first_name": "LUANNE",
        "authorized_official_title_or_position": "EXECTUVIE DIRECTOR",
        "authorized_official_telephone_number": "239-353-1994",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "FL",
            "license": "AD8750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "676919500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Naples, FL
• Providers in Naples, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.