Provider Demographics
NPI:1033493887
Name:GLO-LIZ INC
Entity Type:Organization
Organization Name:GLO-LIZ INC
Other - Org Name:EXCLUSIVE CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-595-5555
Mailing Address - Street 1:1420 N 17TH ST
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-4087
Mailing Address - Country:US
Mailing Address - Phone:361-595-5555
Mailing Address - Fax:361-595-5555
Practice Address - Street 1:1420 N 17TH ST
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-4087
Practice Address - Country:US
Practice Address - Phone:361-595-5555
Practice Address - Fax:361-595-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care