Provider Demographics
NPI:1336719079
Name:CLC INVESTMENTS GROUP CORP
Entity Type:Organization
Organization Name:CLC INVESTMENTS GROUP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROBELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-972-3773
Mailing Address - Street 1:17595 S TAMIAMI TRL STE 112
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4571
Mailing Address - Country:US
Mailing Address - Phone:305-972-3773
Mailing Address - Fax:
Practice Address - Street 1:17595 S TAMIAMI TRL STE 112
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4571
Practice Address - Country:US
Practice Address - Phone:239-990-2935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care