Provider Demographics
NPI:1134384563
Name:NEIGHBORLY CARE NETWORK
Entity type:Organization
Organization Name:NEIGHBORLY CARE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:GOLDEN
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-756-1009
Mailing Address - Street 1:13945 EVERGREEN AVENUE
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:727-288-5015
Practice Address - Street 1:12425 28TH ST N
Practice Address - Street 2:SUITE 200
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1844
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:2008-07-24
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015043614Medicaid