Provider Demographics
NPI:1376685073
Name:NEIGHBORLY CARE NETWORK
Entity Type:Organization
Organization Name:NEIGHBORLY CARE NETWORK
Other - Org Name:NEIGHBORLY HOME DELIVERED MEALS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-573-9444
Mailing Address - Street 1:13945 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-4525
Mailing Address - Country:US
Mailing Address - Phone:727-573-9444
Mailing Address - Fax:727-572-8214
Practice Address - Street 1:13945 EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-4525
Practice Address - Country:US
Practice Address - Phone:727-573-9444
Practice Address - Fax:727-572-8214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN A133NN1002X, 332U00000X
FL8996261QA0600X
FL8944261QA0600X
FL9008261QA0600X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332U00000XSuppliersHome Delivered Meals
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112687300Medicaid